Provider Demographics
NPI:1841407418
Name:FORT YATES IHS HOSPITAL
Entity Type:Organization
Organization Name:FORT YATES IHS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:VOLK
Authorized Official - Suffix:
Authorized Official - Credentials:DIAGRAD TECHNOLOGIST
Authorized Official - Phone:701-854-3831
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:FORT YATES
Mailing Address - State:ND
Mailing Address - Zip Code:58538-0607
Mailing Address - Country:US
Mailing Address - Phone:701-854-3777
Mailing Address - Fax:
Practice Address - Street 1:N 10 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:FORT YATES
Practice Address - State:ND
Practice Address - Zip Code:58538-0527
Practice Address - Country:US
Practice Address - Phone:701-854-3831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital