Provider Demographics
NPI:1558562975
Name:COUNTY OF RANSOM
Entity Type:Organization
Organization Name:COUNTY OF RANSOM
Other - Org Name:RANSOM COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-683-6140
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:403 ELM STREET
Mailing Address - City:LISBON
Mailing Address - State:ND
Mailing Address - Zip Code:58054-0089
Mailing Address - Country:US
Mailing Address - Phone:701-683-5823
Mailing Address - Fax:701-683-0034
Practice Address - Street 1:403 ELM STREET
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:ND
Practice Address - Zip Code:58054-0089
Practice Address - Country:US
Practice Address - Phone:701-683-5823
Practice Address - Fax:701-683-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND58033Medicaid
ND70492Medicare ID - Type Unspecified