Healthcare Provider Details

I. General information

NPI: 1689085797
Provider Name (Legal Business Name): NORTHWOOD DEACONESS HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 TOWNER AVE
LARIMORE ND
58251
US

IV. Provider business mailing address

PO BOX 190
NORTHWOOD ND
58267-0190
US

V. Phone/Fax

Practice location:
  • Phone: 701-431-2999
  • Fax:
Mailing address:
  • Phone: 701-587-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BROCK SHERVA
Title or Position: CEO
Credential:
Phone: 701-587-6060