Healthcare Provider Details

I. General information

NPI: 1932385705
Provider Name (Legal Business Name): MCKENZIE COUNTY HEALTHCARE SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N MAIN ST
WATFORD CITY ND
58854-7310
US

IV. Provider business mailing address

516 N MAIN ST
WATFORD CITY ND
58854-7310
US

V. Phone/Fax

Practice location:
  • Phone: 701-842-3000
  • Fax: 701-842-6248
Mailing address:
  • Phone: 701-842-3000
  • Fax: 701-842-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number338
License Number StateND

VIII. Authorized Official

Name: DANIEL R. KELLY
Title or Position: CEO
Credential:
Phone: 701-842-3000