ST. ANDREW'S BOTTINEAU CLINIC, LLC; NPI #1902803802

Contact Information

ST. ANDREW'S BOTTINEAU CLINIC, LLC

314 OHMER ST
BOTTINEAU, ND 58318-1045

Phone: 701-228-9400
Fax: 701-228-3245
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for ST. ANDREW'S BOTTINEAU CLINIC, LLC

NPI Number 1902803802

LBN Legal business name ST. ANDREW'S BOTTINEAU CLINIC, LLC

Authorized official JODI ATKINSON - (CEO/PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/07/2005

Last updated 04/30/2010 - About 16 years ago

Identifiers

ND	License #	353851
ND	Medicaid	05165
ND	Medicaid	10818

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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