=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598741381
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NELSON-GRIGGS DISTRICT HEALTH UNIT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2005
-----------------------------------------------------
Last Update Date | 10/10/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 116 S MAIN ST
-----------------------------------------------------
City | MCVILLE
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58254-0365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-322-5624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 116 S MAIN ST PO BOX 365
-----------------------------------------------------
City | MCVILLE
-----------------------------------------------------
State | ND
-----------------------------------------------------
Zip | 58254-0365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 701-322-5624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JULIE FERRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 701-322-5624
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------