Provider Demographics
NPI:1023550118
Name:NORTHWOOD DEACONESS HEALTH CENTER
Entity Type:Organization
Organization Name:NORTHWOOD DEACONESS HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-587-6459
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:NORTHWOOD
Mailing Address - State:ND
Mailing Address - Zip Code:58267-0190
Mailing Address - Country:US
Mailing Address - Phone:701-587-6060
Mailing Address - Fax:701-587-6492
Practice Address - Street 1:308 WHINERY STREET
Practice Address - Street 2:
Practice Address - City:BINFORD
Practice Address - State:ND
Practice Address - Zip Code:58416
Practice Address - Country:US
Practice Address - Phone:701-587-6060
Practice Address - Fax:701-587-6492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health