Healthcare Provider Details

I. General information

NPI: 1184528341
Provider Name (Legal Business Name): GREGORY A BURCHILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 2ND ST SE
VALLEY CITY ND
58072-3513
US

IV. Provider business mailing address

11417 36TH ST SE
VALLEY CITY ND
58072-9505
US

V. Phone/Fax

Practice location:
  • Phone: 701-490-1273
  • Fax:
Mailing address:
  • Phone: 701-490-1273
  • Fax: 701-845-1273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: