Provider Demographics
NPI:1548417967
Name:DUNSEITH PUBLIC HEALTH NURSING OFFICE
Entity Type:Organization
Organization Name:DUNSEITH PUBLIC HEALTH NURSING OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-477-6111
Mailing Address - Street 1:#17 MAIN STREET NE
Mailing Address - Street 2:
Mailing Address - City:DUNSEITH
Mailing Address - State:ND
Mailing Address - Zip Code:58329
Mailing Address - Country:US
Mailing Address - Phone:701-244-2472
Mailing Address - Fax:
Practice Address - Street 1:#17 MAIN STREET NE
Practice Address - Street 2:
Practice Address - City:DUNSEITH
Practice Address - State:ND
Practice Address - Zip Code:58329
Practice Address - Country:US
Practice Address - Phone:701-244-2472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QN BURDICK HEALTH CARE MEMORIAL FACILITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND01063Medicaid