Organization
ST LUKE'S HOSPITAL
Active
Other names
Lignite Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH BAKER (ASSISTANT ADMINISTRATOR)
(701) 965-6349
Entity
Organization
Contact information
Practice address
115 MAIN ST., LIGNITE, ND 58752
(701) 933-2220
(701) 933-2220
Mailing address
PO BOX C, CROSBY, ND 58730-0658
(701) 933-2220
(701) 933-2220
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
353430
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11726
NORTH DAKOTA MEDICAID
ND
05
—
5126
—
ND
Enumeration date
08/11/2006
Last updated
08/22/2020
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