Organization
MERCY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KERRY S. MONSON (VP FINANCE/CFO)
(701) 774-7408
Entity
Organization
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
5052A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014507
BLUE CROSS OF ND
ND
05
—
02152
—
ND
05
—
4104464
—
MT
Enumeration date
09/28/2006
Last updated
08/22/2020
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