Organization
FIRST DISTRICT HEALTH UNIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA R CLUTE (EXECUTIVE OFFICER)
(701) 852-1376
Entity
Organization
Contact information
Practice address
801 11TH AVE SW, MINOT, ND 58701-4274
(701) 852-1376
(701) 852-5043
Mailing address
801 11 AVE. SW, PO BOX 1268, MINOT, ND 58702-1268
(701) 852-1376
(701) 852-5043
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10581
BLUE CROSS BLUE SHIELD
ND
05
—
249326
—
ND
05
—
249327
—
ND
01
—
600000290
RR MEDICARE
ND
Enumeration date
10/24/2006
Last updated
05/17/2016
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