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General NPI Number Information
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NPI Number | 1417093949
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Entity Type | Organization
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Legal Business Name | PEMBINA COUNTY MEMORIAL HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 301 MOUNTAIN ST E
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City | CAVALIER
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State | ND
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Zip | 58220-4015
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Country | US
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Telephone | 701-265-6307
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 380
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City | CAVALIER
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State | ND
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Zip | 58220-0380
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LISA R LETEXIER
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Credential | CEO
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Telephone | 701-265-6228
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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 |
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License Number State |
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