Organization
COOPERSTOWN MEDICAL CENTER
Active
Parent organization
COOPERSTOWN MEDICAL CENTER
Other names
Dakota Regional Medical Center, Cooperstown Medical Center Critical Access Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOPERSTOWN MEDICAL CENTER
Authorized official
KELLEY SHAWN (ADMIN ASSISTANT/CREDENTIALING)
(701) 786-1709
Entity
Organization
Contact information
Practice address
107 12TH ST S, COOPERSTOWN, ND 58425-4501
(701) 786-1700
(701) 786-7121
Mailing address
107 12TH ST S, COOPERSTOWN, ND 58425-4501
(701) 786-1700
(701) 786-7121
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
5010P
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01009717
PREFERED ONE
—
05
—
1009
—
ND
01
—
489
BLUE CROSS BLUE SHIELD
ND
01
—
87726
MEDICA
—
Enumeration date
09/22/2006
Last updated
08/29/2023
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