Provider Demographics
NPI:1083889430
Name:UPPER MISSOURI DISTRICT HEALTH UNIT
Entity Type:Organization
Organization Name:UPPER MISSOURI DISTRICT HEALTH UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-774-6418
Mailing Address - Street 1:110 W BROADWAY
Mailing Address - Street 2:STE 101
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-6056
Mailing Address - Country:US
Mailing Address - Phone:701-774-6400
Mailing Address - Fax:701-577-8536
Practice Address - Street 1:110 W BROADWAY
Practice Address - Street 2:STE 101
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-6056
Practice Address - Country:US
Practice Address - Phone:701-774-6400
Practice Address - Fax:701-577-8536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND31058OtherBC BS OF ND
ND31057OtherBC BS OF ND
ND31060OtherBC BS OF ND
ND31059OtherBC BS OF ND