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NPI Code Detail

MEDICARE: SPIRIT LAKE OKICIYAPI

MEDICARE: SPIRIT LAKE OKICIYAPI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1343900000XNon-emergency Medical Transport (VAN)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245723410
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPIRIT LAKE OKICIYAPI
Provider Business Mailing Address
First Line : 816 3RD AVE N
Second Line :
City : FORT TOTTEN
State : ND
Zip : 58335-9998
Country : US
Telephone Number : 701-766-4862
Fax Number : 701-766-4878
Provider Business Practice Location Address
First Line : 816 3RD AVE N
Second Line :
City : FORT TOTTEN
State : ND
Zip : 58335-9998
Country : US
Telephone Number : 701-766-4862
Fax Number : 701-766-4878
Authorized Official
Title or Position : 3RD PARTY BILLING MANAGER
Name : LINDA SUE PELTIER
Credential :
Telephone Number : 701-766-1667
Provider Enumeration Date : 06/12/2018
Last Update Date : 10/29/2020

Similar Medicare Providers

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Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
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Practice Fax:
1124206248 — MS. LINDA F DUCKWITZ LICSW, LAC
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1841619798 — SPIRIT LAKE TRIBE
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1710545231 — PUBLIC HEALTH NURSING
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FORT TOTTEN, ND
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1588209084 — BERTHA GAIL OLAFSON
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1043855539 — JESSICA TWEETON RN
Practice Location Address:
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Directions to “SPIRIT LAKE OKICIYAPI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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