Healthcare Provider Details

I. General information

NPI: 1376584623
Provider Name (Legal Business Name): WISHEK HOSPITAL-CLINIC ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 4TH AVE S
WISHEK ND
58495
US

IV. Provider business mailing address

PO BOX 647
WISHEK ND
58495-0647
US

V. Phone/Fax

Practice location:
  • Phone: 701-452-2364
  • Fax: 701-452-4276
Mailing address:
  • Phone: 701-452-2326
  • Fax: 701-452-2179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number5053A
License Number StateND

VIII. Authorized Official

Name: LUKAS FISCHER
Title or Position: CEO
Credential:
Phone: 701-452-2326