Lilycare Clinic

LBN: Tracie M Mallberg Md Pc
Lilycare Clinic is an health care organization with primary practice located at 550 13Th Ave E , West Fargo ND 58078-3360. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Tracie M Mallberg Md Pc can be contacted via phone (701) 356-5459, or through Mallberg, Tracie M via phone (701) 356-5459.

Contact Information

Primary practice address
550 13Th Ave E West Fargo ND 58078-3360
Phone: (701) 356-5459
Fax: (701) 356-3764
Website:
Map and Directions
Authorized official contact:
Name: Mallberg, Tracie M Doctor of Medicine (MD)
Phone: (701) 356-5459

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 9395 North Dakota

Profile Details

NPI number 1023282969
LBN Legal business name Tracie M Mallberg Md Pc
DBA Doing business as Lilycare Clinic
Authorized official Mallberg, Tracie M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2008
Last updated Aug 1st, 2008 - about 16 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 1023282969 NPPES
North Dakota MEDICAID 14788

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