JACOBSON MEMORIAL HOSPITAL CARE CENTER (NPI# 1043649486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043649486 |
| Entity Type | Organization |
| Organization Name | JACOBSON MEMORIAL HOSPITAL CARE CENTER |
| Other Organization Name | RICHARDTON CLINIC |
| Practice Address |
215 3rd Ave W Richardton ND 58652-7109 |
| Mailing Address |
Po Box 367 Elgin ND 58533 |
| Practice Telephone | 7019743372 |
| Practice Fax Number | 7015842397 |
| Mailing Telephone | 7015842792 |
| Mailing Fax Number | 7015842397 |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2019-11-12 |
| Authorized Official Name | THEO STOLLER (CEO) |
| Authorized Official Telephone | 7015842792 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACOBSON MEMORIAL HOSPITAL CARE CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
ND | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 1452461 | 05 |
| Other Name | Type Code |
|---|---|
| Richardton Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629165915 | Jacobson Memorial Hospital Care Center | Skilled Nursing Facility | 601 E Street N, Elgin, ND 58533 | 2006-10-06 |
| 1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
| 1376651463 | Jacobson Memorial Hospital Care Center | Clinic/Center | 811 Main St, Hebron, ND 58638 | 2006-08-28 |
| 1003929944 | Jacobson Memorial Hospital Care Center | Clinic/Center | 602 Ash Ave E, Glen Ullin, ND 58631 | 2006-08-16 |
| 1336196039 | Jacobson Memorial Hospital Care Center | General Acute Care Hospital | 601 East St N, Elgin, ND 58533-7105 | 2006-05-28 |
| 1184002347 | Jacobson Memorial Hospital Care Center | Long Term Care Hospital | 601 East St N, Elgin, ND 58533-7105 | 2015-05-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | JACOBSON MEMORIAL HOSPITAL CARE CENTER | 601 East St N, Elgin, ND 58533-7105 |
| Street Address |
215 3RD AVE W |
| City | RICHARDTON |
| State | ND |
| Zip Code | 58652-7109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457588360 | Hoff Chiropractic | Clinic/Center | 108 North Avenue West, Richardton, ND 58652 | 2009-06-18 |
| 1336260520 | Lee A Hoff | Chiropractor | 108 North Ave West, Richardton, ND 58652 | 2007-04-03 |
| 1891889879 | Michael Emond | Physician Assistant | 212 3rd Avenue West, Richardton, ND 58652 | 2006-10-03 |
| 1295956852 | Lindsey Fettig | Occupational Therapist | 100 Elm Ave, New Salem, ND 58652 | 2007-05-01 |
| 1881677094 | Gregory Justin Johnson | Dentist | 200 3rd Ave W, Richardton, ND 58652-0333 | 2005-11-22 |
| 1184669616 | S & V Inc | Pharmacy | 116 N Ave E, Richardton, ND 58652-0910 | 2006-06-18 |
| 1750764973 | Megan Hueske | Optometrist | 50 3rd Ave E, Richardton, ND 58652-7006 | 2015-07-07 |
| 1023359072 | Richardton Taylor Rural Ambulance District | Ambulance | 112 N Main St, Richardton, ND 58652-7038 | 2013-03-14 |
| 1629677489 | Darcy Uzdilla | Technician | 311 N Main St, Richardton, ND 58652-7043 | 2020-10-22 |
| 1093925752 | Doreen Studsrud | Pharmacist | 116 N Ave E, Richardton, ND 58652-7044 | 2007-05-23 |
| Find all providers in zip 58652 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457963274 | Nelson County Health System | Clinic/Center | 115 South St E, Michigan, ND 58259-4120 | 2020-08-21 |
| 1821637828 | Christian Unity Hospital Corporation | Clinic/Center | 503 Park St W Ste B, Park River, ND 58270-4138 | 2019-12-23 |
| 1023550118 | Northwood Deaconess Health Center | Clinic/Center | 308 Whinery Street, Binford, ND 58416 | 2016-11-07 |
| 1689085797 | Northwood Deaconess Health Center | Clinic/Center | 611 Towner Ave, Larimore, ND 58251 | 2014-05-12 |
| 1700064599 | Rolla Eye Clinic | Clinic/Center | 118 3rd St. Ne, Rolla, ND 58367-1170 | 2008-02-05 |
| 1891859948 | Nelson County Health System | Clinic/Center | 117 2nd St West, Lakota, ND 58344 | 2006-12-21 |
| 1760570394 | West River Health Services | Clinic/Center | 211 Main Street, Scranton, ND 58653 | 2006-10-10 |
| 1942398508 | West River Health Services | Clinic/Center | 420 Pacific Ave, Mott, ND 58646 | 2006-10-10 |
| 1871691519 | Jacobson Memorial Hospital Care Center | Clinic/Center | 603 East St N, Elgin, ND 58533-7105 | 2006-09-20 |
| 1376651463 | Jacobson Memorial Hospital Care Center | Clinic/Center | 811 Main St, Hebron, ND 58638 | 2006-08-28 |
| Find all providers with the same taxonomy | ||||
| City | RICHARDTON |
| Zip Code | 58652 |
Please comment or provide details below to improve the information on JACOBSON MEMORIAL HOSPITAL CARE CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.