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Organization
SOUTHEAST MEDICAL CENTER PC
Active
Organization
SOUTHEAST MEDICAL CENTER PC
Active
Parent organization
SOUTHEAT MEDICAL CENTER PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAT MEDICAL CENTER PC
Authorized official
THERESA KELLY (ADMINISTRATOR)
(701) 742-3267
Entity
Organization
Contact information
Practice address
102 10TH AVENUE WEST, LISBON, ND 58054-1097
(701) 683-2214
(701) 683-2130
Mailing address
PO BOX 50, OAKES, ND 58474-0050
(701) 742-3267
(701) 742-3201
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/31/2006
Last updated
06/09/2009
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