| Cooperstown Medical Center | |
|
117 2nd St W Lakota ND 58344-7320 | |
| (701) 786-1700 | |
| (701) 786-7121 |
| Full Name | Cooperstown Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 2nd St W, Lakota, North Dakota |
| Authorized Official Name and Position | Kelley Shawn (ADMIN ASSIST/CREDENTIALING) |
| Authorized Official Contact | 7017861709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cooperstown Medical Center 107 12th St S Cooperstown ND 58425-4501 Ph: (701) 786-1709 | Cooperstown Medical Center 117 2nd St W Lakota ND 58344-7320 Ph: (701) 786-1700 |
| NPI Number | 1821760679 |
|---|---|
| Provider Enumeration Date | 09/30/2021 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 5698687689 |
|---|---|
| Medicare Enrollment ID | O20211111000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821760679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Nelson County Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 2nd St West, Lakota, ND 58344 Phone: 701-247-2226 Fax: 701-247-2266 |