Organization · Type 2 NPI

Fort Yates Indian Health Service Hospital

Federal Public Health Clinic/Center · Cannonball, ND

NPI number 1336286798 Active

Practice location

6998 Weasel Street
Cannonball, ND 58528

Call (701) 854-3831 Map

Fax (701) 854-7411

Mailing address

PO Box J
Fort Yates, ND 58538-0527

Specialties and licenses

Taxonomy	Code	License
Federal Public Health Clinic/Center Primary	261QP0904X	None listed

Federal Public Health Clinic/Center: Definition to come...

NPI record

NPI: 1336286798
Entity type: Organization (Type 2)
Issued: Feb 1, 2007
Last updated: Aug 9, 2018
Status: Active
Subpart: Yes of Fort Yates Indian Health Service Hospital

Other names

<unavail>
Cannonball Clinic · doing business as
Cannonball Clinic · doing business as

Authorized official

Jana Rhea Gipp
Chief Executive Officer
(701) 854-8211

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1336286798

Fort Yates Indian Health Service Hospital's National Provider Identifier is 1336286798, issued on Feb 1, 2007. The primary taxonomy on file is Federal Public Health Clinic/Center (261QP0904X), and the practice location is in Cannonball, ND. The record was last updated on Aug 9, 2018.