Provider Demographics
NPI:1891859948
Name:NELSON COUNTY HEALTH SYSTEM
Entity Type:Organization
Organization Name:NELSON COUNTY HEALTH SYSTEM
Other - Org Name:LAKOTA HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-322-4328
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:MCVILLE
Mailing Address - State:ND
Mailing Address - Zip Code:58254-0367
Mailing Address - Country:US
Mailing Address - Phone:701-247-2226
Mailing Address - Fax:701-247-2266
Practice Address - Street 1:117 2ND ST WEST
Practice Address - Street 2:
Practice Address - City:LAKOTA
Practice Address - State:ND
Practice Address - Zip Code:58344
Practice Address - Country:US
Practice Address - Phone:701-247-2226
Practice Address - Fax:701-247-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND020720OtherBLUE CROSS BLUE SHIELD
ND011682Medicaid
ND05158Medicaid
ND301002OtherBLUE CROSS BLUE SHIELD
ND353400Medicare ID - Type Unspecified
ND020720OtherBLUE CROSS BLUE SHIELD