Cannonball Clinic

LBN: Fort Yates Indian Health Service Hospital
Cannonball Clinic is an health care organization with primary practice located at 6998 Weasel Street , Cannonball ND 58528. The organization recently has only one registered license in Ambulatory Health Care Facilities / Public Health, Federal, which is considered as the primary health care specialty. Fort Yates Indian Health Service Hospital can be contacted via phone (701) 854-3831, or through Gipp, Jana Rhea via phone (701) 854-8211.

Contact Information

Primary practice address
6998 Weasel Street Cannonball ND 58528
Phone: (701) 854-3831
Fax: (701) 854-7411
Website:
Map and Directions
Authorized official contact:
Name: Gipp, Jana Rhea
Phone: (701) 854-8211

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Public Health, Federal 261QP0904X

Profile Details

NPI number 1336286798
LBN Legal business name Fort Yates Indian Health Service Hospital
DBA Doing business as Cannonball Clinic
Authorized official Gipp, Jana Rhea
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 1st, 2007
Last updated Aug 9th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336286798 NPPES
North Dakota MEDICAID 1459056

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