Organization
WHITE EARTH HEALTH CENTER
Active
Parent organization
WHITE EARTH HEALTH CENTER
Other names
Naytahwaush Health Station
Organization subpart
Yes
Provider details
NPI number
Legal business name
WHITE EARTH HEALTH CENTER
Authorized official
FRED C KOEBRICK (CHIEF EXECUTIVE OFFICER (CEO))
(218) 983-6214
Entity
Organization
Contact information
Practice address
NAYTAHWAUSH HEALTH STATION 238 CHURCH STREET, NAYTAHWAUSH, MN 56566
(218) 935-2238
(218) 935-5085
Mailing address
40520 COUNTY HIGHWAY 34, OGEMA, MN 56569-9612
(218) 983-4300
(218) 983-6217
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246753400
—
MN
01
—
5511210002
DMEPOS SUPPLIER NUMBER
MN
Enumeration date
05/11/2007
Last updated
11/30/2009
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