Provider Demographics
NPI:1518068949
Name:SOUTHWEST HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:SOUTHWEST HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-523-4131
Mailing Address - Street 1:PO BOX C
Mailing Address - Street 2:
Mailing Address - City:BOWMAN
Mailing Address - State:ND
Mailing Address - Zip Code:58623-0009
Mailing Address - Country:US
Mailing Address - Phone:701-523-5265
Mailing Address - Fax:701-523-7104
Practice Address - Street 1:14 6TH AVE SW
Practice Address - Street 2:
Practice Address - City:BOWMAN
Practice Address - State:ND
Practice Address - Zip Code:58623-0009
Practice Address - Country:US
Practice Address - Phone:701-523-5265
Practice Address - Fax:701-523-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5006P275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND004317OtherSWING BED
ND01956Medicaid
ND004317OtherSWING BED