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CAH351312-01 NORTHWOOD DEACONESS HEALTH CENTER (Active)
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Main Details
Name
NORTHWOOD DEACONESS HEALTH CENTER
Subdivision Name
Health Center Clinic Larimore
Type
Critical Access Hospital
Rural
No
340B ID
CAH351312-01
Medicare Provider Number
351312
Outpatient Facility Provider Number
353456
Additional Details
Current Program Status
Active
Registration Date
4/2/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/19/2015
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Northwood Deaconess Health Center
Greta McKenzie, CFO
(701) 587-6459
Primary Contact
Northwood Deaconess Health Center
Jenny A Metz, Pharmacy Manager
(701) 587-6480
Addresses
Street Address
611 Towner Ave
Larimore, ND 58251
Billing Address
Northwood Deaconess Health Center
PO Box 190
Northwood, ND 58267
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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