1144418906 NPI number — COUNTY OF LAMOURE OFFICE OF AUDITOR

Table of content: (NPI 1144418906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144418906 NPI number — COUNTY OF LAMOURE OFFICE OF AUDITOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF LAMOURE OFFICE OF AUDITOR
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144418906
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 692
Provider Second Line Business Mailing Address:
100 1 AVE SW
Provider Business Mailing Address City Name:
LAMOURE
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58458-0692
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-883-5356
Provider Business Mailing Address Fax Number:
701-883-5015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 1ST AVENUE SOUTHWEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAMOURE
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-883-5356
Provider Business Practice Location Address Fax Number:
701-883-5356
Provider Enumeration Date:
10/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HANSON
Authorized Official First Name:
LESILE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DON
Authorized Official Telephone Number:
701-883-5356

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  E-3023 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 52155 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com