Healthcare Provider Details

I. General information

NPI: 1235295593
Provider Name (Legal Business Name): RICHARDTON HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8885 HIGHWAY 10
RICHARDTON ND
58652-9714
US

IV. Provider business mailing address

8885 HIGHWAY 10
RICHARDTON ND
58652-9714
US

V. Phone/Fax

Practice location:
  • Phone: 701-974-3304
  • Fax: 701-974-3307
Mailing address:
  • Phone: 701-974-3304
  • Fax: 701-974-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1098A
License Number StateND

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierDB5850
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICARE RAILROAD CARRIER GRP PTAN
# 2
Identifier1451396
Identifier TypeMEDICAID
Identifier StateND
Identifier Issuer

VIII. Authorized Official

Name: MARILYN RIPPY
Title or Position: CEO
Credential: RN/DON
Phone: 701-974-3304