| Garrison Memorial Hospital | |
|
437 3rd Ave Se Garrison ND 58540-7235 | |
| (701) 463-2245 | |
| (701) 463-6543 |
| Full Name | Garrison Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 437 3rd Ave Se, Garrison, North Dakota |
| Authorized Official Name and Position | Tod S Graeber (ADMINISTRATOR) |
| Authorized Official Contact | 7014636505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garrison Memorial Hospital 437 3rd Ave Se Po Box 9 Garrison ND 58540-7235 Ph: (701) 463-2245 | Garrison Memorial Hospital 437 3rd Ave Se Garrison ND 58540-7235 Ph: (701) 463-2245 |
| NPI Number | 1952381873 |
|---|---|
| Provider Enumeration Date | 01/18/2006 |
| Last Update Date | 10/07/2014 |
| Medicare PECOS PAC ID | 0143206946 |
|---|---|
| Medicare Enrollment ID | O20040624000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952381873 | NPI | - | NPPES |
| 17125 | Medicaid | ND | |
| 9555 | Other | ND | BLUE CROSS/BLUE SHIELD |
| 5083 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Jon E Dornacker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801804588 PECOS PAC ID: 2466400312 Enrollment ID: I20050106000874 |
| Provider Name | Susan G Wardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235213695 PECOS PAC ID: 3870543507 Enrollment ID: I20050131000086 |
| Provider Name | Cassandra B Haider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750698585 PECOS PAC ID: 3173716644 Enrollment ID: I20101018000692 |
| Provider Name | Amanda H Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346616661 PECOS PAC ID: 9436467412 Enrollment ID: I20150925000144 |
| Provider Name | Ermelinda Kerpi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508249707 PECOS PAC ID: 3072820752 Enrollment ID: I20180820001922 |
| Provider Name | Forrest L Hirsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437645306 PECOS PAC ID: 6507117280 Enrollment ID: I20180919000903 |
| Provider Name | Elizabeth Ashley Diffely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245914563 PECOS PAC ID: 4284080292 Enrollment ID: I20231027000924 |