| Fort Yates Indian Health Service Hospital | |
|
6998 Weasel Street Cannonball ND 58528 | |
| (701) 854-3831 | |
| (701) 854-7411 |
| Full Name | Fort Yates Indian Health Service Hospital |
|---|---|
| Speciality | Clinic/center - Public Health, Federal |
| Location | 6998 Weasel Street, Cannonball, North Dakota |
| Authorized Official Name and Position | Jana Rhea Gipp (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7018548211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Yates Indian Health Service Hospital Po Box J Fort Yates ND 58538-0527 Ph: (701) 854-3831 | Fort Yates Indian Health Service Hospital 6998 Weasel Street Cannonball ND 58528 Ph: (701) 854-3831 |
| NPI Number | 1336286798 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336286798 | NPI | - | NPPES |
| 1459056 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |