Organization
COOPERSTOWN MEDICAL CENTER
Active
Parent organization
COOPERSTOWN MEDICAL CENTER
Other names
Dakota Regional Medical Center, DRMC Rural Health Clinic, CMC Rural Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOPERSTOWN MEDICAL CENTER
Authorized official
KELLEY SHAWN (ADMIN ASSIST/CREDENTIALING)
(701) 786-1709
Entity
Organization
Contact information
Practice address
107 12TH ST S, COOPERSTOWN, ND 58425-4501
(701) 786-1709
(701) 786-7121
Mailing address
107 12TH ST S, COOPERSTOWN, ND 58425-4501
(701) 786-1709
(701) 786-7121
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4770
BLUE CROSS BLUE SHIELD
ND
05
—
5000
—
ND
Enumeration date
01/30/2007
Last updated
09/08/2023
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