Provider Demographics
NPI:1295772804
Name:WISHEK HOSPITAL-CLINIC ASSOCIATION
Entity type:Organization
Organization Name:WISHEK HOSPITAL-CLINIC ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:VILHAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-452-2326
Mailing Address - Street 1:1007 4TH AVE S
Mailing Address - Street 2:PO BOX 647
Mailing Address - City:WISHEK
Mailing Address - State:ND
Mailing Address - Zip Code:58495-0647
Mailing Address - Country:US
Mailing Address - Phone:701-452-2326
Mailing Address - Fax:701-452-2392
Practice Address - Street 1:1007 4TH AVE S
Practice Address - Street 2:
Practice Address - City:WISHEK
Practice Address - State:ND
Practice Address - Zip Code:58495-0647
Practice Address - Country:US
Practice Address - Phone:701-452-3207
Practice Address - Fax:701-452-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5053A282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND011858OtherBCBS AMBULANCE PROV#
ND50795Medicaid
ND000679OtherBCBS
ND1060Medicaid
ND351321Medicare ID - Type UnspecifiedMCARE PROVIDER NUMBER