Organization
TIOGA MEDICAL CENTER
Active
Other names
Tioga Medical Center Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL K. PEDERSON (PRESIDENT/CEO)
(701) 664-3305
Entity
Organization
Contact information
Practice address
810 N WELO ST, TIOGA, ND 58852-7157
(701) 664-3368
(701) 664-3300
Mailing address
PO BOX 159, TIOGA, ND 58852-0159
(701) 664-3368
(701) 664-3300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
9333
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00327001
BCBSND
ND
05
—
10158
—
ND
Enumeration date
04/21/2006
Last updated
08/30/2016
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