Organization
SPIRIT LAKE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARREN MARTELL (BUSINESS OFFICE MANAGER)
(701) 766-1600
Entity
Organization
Contact information
Practice address
3883 74TH AVE NE, FT TOTTEN, ND 58301
(701) 766-1612
Mailing address
PO BOX 309, 3883 74TH AVE NE, FORT TOTTEN, ND 58335-0309
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
AU46983207
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01056
—
ND
01
—
3503693
NCPDP
ND
Enumeration date
12/19/2006
Last updated
08/22/2020
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