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General NPI Number Information
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NPI Number | 1902824576
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Entity Type | Organization
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Legal Business Name | MERCY MEDICAL CENTER
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1301 15TH AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-3821
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Country | US
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Telephone | 701-774-7401
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Fax | 701-774-7479
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Provider Business Mailing Address
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Address Line | 1301 15TH AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-3821
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Country | US
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Telephone | 701-774-7401
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Fax | 701-774-7479
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Authorized Official
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Title or Position | VP - OPERATIONAL FINANCE
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Name | JOSEPH RUARK
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Credential |
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Telephone | 701-774-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 5052
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 5052A
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License Number State | ND
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