Provider Demographics
NPI:1952511438
Name:EMMONS DISTRICT HEALTH UNIT
Entity Type:Organization
Organization Name:EMMONS DISTRICT HEALTH UNIT
Other - Org Name:EMMONS COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-254-4027
Mailing Address - Street 1:118 E SPRUCE AVE
Mailing Address - Street 2:PO BOX 636
Mailing Address - City:LINTON
Mailing Address - State:ND
Mailing Address - Zip Code:58552
Mailing Address - Country:US
Mailing Address - Phone:701-254-4027
Mailing Address - Fax:701-254-4057
Practice Address - Street 1:118 E SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:LINTON
Practice Address - State:ND
Practice Address - Zip Code:58552
Practice Address - Country:US
Practice Address - Phone:701-254-4027
Practice Address - Fax:701-254-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND57993Medicaid
ND57993Medicaid