Provider Demographics
NPI:1083224067
Name:MCKENZIE COUNTY HEALTHCARE SYSTEMS INC
Entity Type:Organization
Organization Name:MCKENZIE COUNTY HEALTHCARE SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BLAHOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-444-8746
Mailing Address - Street 1:709 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WATFORD CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58854-7628
Mailing Address - Country:US
Mailing Address - Phone:701-842-8746
Mailing Address - Fax:701-842-4025
Practice Address - Street 1:709 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:WATFORD CITY
Practice Address - State:ND
Practice Address - Zip Code:58854-7628
Practice Address - Country:US
Practice Address - Phone:701-842-3771
Practice Address - Fax:701-842-4025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty