Organization
TIOGA MEDICAL CENTER HOSPITAL
Active
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) 664-3305
(701) 664-2240
Mailing address
PO BOX 159, TIOGA, ND 58852-0159
(701) 664-3305
(701) 664-2240
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00059001
BCBSND HOSP CLINIC NUMBER
ND
Enumeration date
10/03/2006
Last updated
08/22/2020
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