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NPI Code Detail

MEDICARE: MCKENZIE COUNTY HEALTHCARE SYSTEMS INC

MEDICARE: MCKENZIE COUNTY HEALTHCARE SYSTEMS INC
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
1311Z00000XCustodial Care Facility

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 : 1689698193
Entity Type Code : Organization
Provider Name (Legal Business Name) : MCKENZIE COUNTY HEALTHCARE SYSTEMS INC
Provider Business Mailing Address
First Line : 709 4TH AVE NE
Second Line :
City : WATFORD CITY
State : ND
Zip : 58854-7628
Country : US
Telephone Number : 701-444-2331
Fax Number : 701-444-4629
Provider Business Practice Location Address
First Line : 709 4TH AVE NE
Second Line :
City : WATFORD CITY
State : ND
Zip : 58854-7628
Country : US
Telephone Number : 701-444-2331
Fax Number : 701-444-4629
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DANIEL R. KELLY
Credential :
Telephone Number : 701-842-3000
Provider Enumeration Date : 07/27/2006
Last Update Date : 12/12/2024

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