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General NPI Number Information
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NPI Number | 1083625354
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Entity Type | Organization
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Legal Business Name | THREE AFFILIATED TRIBES KIDNEY DIALYSIS UNIT
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1250 ELBOWOODS LOOP
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City | NEW TOWN
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State | ND
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Zip | 58763
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Country | US
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Telephone | 701-627-4840
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Fax | 701-627-4842
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Provider Business Mailing Address
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Address Line | 1250 ELBOWOODS LOOP
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City | NEW TOWN
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State | ND
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Zip | 58763
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Country | US
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Telephone | 701-627-4840
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Fax | 701-627-4842
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELIZABETH MARIE LONE BEAR
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Credential |
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Telephone | 701-627-4840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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