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General NPI Number Information
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NPI Number | 1174597173
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Entity Type | Organization
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Legal Business Name | HAZEN MEMORIAL HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 517 8TH AVE NE
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City | HAZEN
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State | ND
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Zip | 58545-4638
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Country | US
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Telephone | 701-748-2256
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Fax | 701-748-2257
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Provider Business Mailing Address
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Address Line | 517 8TH AVE NE
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City | HAZEN
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State | ND
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Zip | 58545-4638
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Country | US
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Telephone | 701-748-2256
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Fax | 701-748-2257
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Authorized Official
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Title or Position | CEO
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Name | JAMES MARSHALL
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Credential |
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Telephone | 701-748-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 353444
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License Number State | ND
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