Organization
TIOGA MEDICAL CENTER
Active
Other names
Tioga Medical Center LTC
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
314000000X
Skilled Nursing Facility
Primary
1051A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016
BCBSND
ND
05
—
30176
—
ND
Enumeration date
02/15/2006
Last updated
08/04/2014
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