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General NPI Number Information
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NPI Number | 1336201433
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Entity Type | Organization
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Legal Business Name | CAVALIER COUNTY MEMORIAL HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 909 2ND ST
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City | LANGDON
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State | ND
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Zip | 58249-2407
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Country | US
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Telephone | 701-256-6100
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Fax | 701-256-2170
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Provider Business Mailing Address
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Address Line | 909 2ND ST
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City | LANGDON
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State | ND
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Zip | 58249-2407
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Country | US
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Telephone | 701-256-6100
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Fax | 701-256-2170
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MR. JEFFERY STANLEY
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Credential |
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Telephone | 701-256-6180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 5029
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License Number State | ND
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