Provider Demographics
NPI:1770161770
Name:NELSON COUNTY HEALTH SYSTEM
Entity type:Organization
Organization Name:NELSON COUNTY HEALTH SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FORDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-322-4328
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:MCVILLE
Mailing Address - State:ND
Mailing Address - Zip Code:58254-0307
Mailing Address - Country:US
Mailing Address - Phone:701-322-4328
Mailing Address - Fax:701-322-2250
Practice Address - Street 1:108 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MCVILLE
Practice Address - State:ND
Practice Address - Zip Code:58254-4203
Practice Address - Country:US
Practice Address - Phone:701-322-4328
Practice Address - Fax:701-322-2250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NELSON COUNTY HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDND248945Medicaid