BELCOURT IHS HOSPITAL (NPI# 1790811503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790811503 |
| Entity Type | Organization |
| Organization Name | BELCOURT IHS HOSPITAL |
| Other Organization Name | QUENTIN N BURDICK IHS PHARMACY |
| Practice Address |
1st Main St Highway 5 Belcourt ND 58316 |
| Mailing Address |
3105 Solutions Ctr Chicago IL 60677-3001 |
| Practice Telephone | 7014778426 |
| Practice Fax Number | 7014778436 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2013-03-07 |
| Authorized Official Name | JAMES CUMMINGS (PHARMACY PROGRAM SPECIALIST) |
| Authorized Official Telephone | 4059516086 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 01063 | 05 | |
| NCPDP PROVIDER IDENTIFICATION NUMBER | 3503871 | 01 | |
| ND | 1063QN | 05 |
| Other Name | Type Code |
|---|---|
| QUENTIN N BURDICK IHS PHARMACY | Doing Business As Name - Organization |
| Street Address |
1ST MAIN ST HIGHWAY 5 |
| City | BELCOURT |
| State | ND |
| Zip Code | 58316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063012656 | Ryan Wickerham | Technician | 9862 46th Ave Ne 1191 Kent Addition, 1191, Belcourt, ND 58316 | 2020-10-31 |
| 1396345146 | Melinda Marie Desjarlais | Technician | 9826 46th Ave Ne, Belcourt, ND 58316 | 2020-10-30 |
| 1417591140 | Molly Sue Beyer | Nurse Practitioner | 1300 Hospital Loop Road, Belcourt, ND 58316 | 2019-11-06 |
| 1114430519 | John Robert Kerr | Dentist | Quentin N. Burdick Memorial Hospital 1300 Hospital Loop, Belcourt, ND 58316 | 2017-11-08 |
| 1174979694 | Jan Birkland | Case Manager/Care Coordinator | 4051 Highway 281, Belcourt, ND 58316 | 2016-05-13 |
| 1841644291 | Berry James Poitra | Pharmacist | Moonlight Drive Highway 5, Belcourt, ND 58316 | 2016-04-21 |
| 1114380748 | Bernice Delorme | Social Worker | Bldg 152, John Norquay Street, Belcourt, ND 58316 | 2016-03-31 |
| 1326425943 | Turtle Mountain Band of Chippewa | Private Vehicle | 1023 Chief Little Shell Street Ne, Belcourt, ND 58316 | 2015-05-04 |
| 1336535038 | Turlte Mountain Maternal Child Health Program | Case Management | Building 150 John Norquay Street, Belcourt, ND 58316 | 2015-04-09 |
| 1982006672 | Eugene Monette | Physical Therapist | 4278 Bia Road 8, Belcourt, ND 58316 | 2014-09-24 |
| Find all providers in zip 58316 | ||||
| Taxonomy Code | 332800000X |
| Grouping | Suppliers |
| Classification | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |
| Notes: Source: The Medicare Prescription Drug, Improvement and Modernization Act of 2003 [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770613325 | Fort Yates Indian Hosp Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1010 N River Rd, Fort Yates, ND 58538 | 2007-03-06 |
| 1124284914 | Three Affiliated Tribes White Shield Healthcare Telepharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2 Main Street B, Roseglen, ND 58775 | 2008-08-01 |
| 1811153505 | Three Affiliated Tribes Twin Buttes Healthcare Tele-pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 726 80th Ave Nw, Halliday, ND 58636-4001 | 2008-08-01 |
| 1801052592 | Three Affiliated Tribes Parshall Healthcare Tele-pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 107 3rd St Se, Parshall, ND 58770 | 2008-08-01 |
| 1063678779 | Three Affiliated Tribes Manadree Health Care Tele-pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 305 Main Street, Mandaree, ND 58757 | 2008-08-01 |
| 1467611970 | Elbowoods Memorial Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1058 College Dr, New Town, ND 58763-9112 | 2008-06-09 |
| 1689895427 | Trenton Community Clinic Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 331 4th Ave E, Hwy 1804, Trenton, ND 58853-9998 | 2007-05-01 |
| 1568592137 | Spirit Lake Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2007-03-06 |
| 1851428288 | Fort Berthold Ihs Health Center Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 1 Minni Tohe Dr, New Town, ND 58763-4400 | 2007-02-27 |
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| 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.