Fairlight Medical Center, NPI 1811162811
Urgent Care Clinic/Center in Williston, ND, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1811162811
NPI Entity Type Organization
Provider Name Fairlight Medical Center
Other Name
Subpart of Organization Williston Radiology Consultants Pc
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 3 4th St E, Williston, ND, US
Provider Mailing Address 3 East 4th Street, Po Box 1148, Williston, ND, US, 588021148
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name DR. MD Leszek J Jaszczak
Official Position PRESIDENT/OWNER
Phone 701-577-6337

Primary Taxonomy

Taxonomy Code

261QU0200X

Taxonomy Name Urgent Care Clinic/Center
Classification

Clinic/Center

Group

Ambulatory Health Care Facilities

License No. 6414
License State ND
Description Definition to come...

Other Organization Name

Williston Radiology Consultants
Other Name

Business Address

Fairlight Medical Center
3 4th St E

Williston, ND, US

Phone: 701-577-6337
Fax: 701-577-4867

Mailing Address

Fairlight Medical Center
3 East 4th Street
Po Box 1148
Williston, ND, US
ZIP 588021148
Phone: 701-577-6337
Fax: 701-577-4867

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
109956169 ND DUNS 01
269-961-7243 ND TPIN 01
621-111 ND NAICS 01
010182 ND MEDICAID 05
0406731 MT MEDICAID 05

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NPI Name Taxonomy Address

1417688698

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LCWS Samantha Navratil

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LPCC Naomi Tabassum

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MR. LCSW Anthony Miller

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LPCC Trista Schon

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DR. DDS Jason O Dahl

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LPCC Ashley Vogel

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MS. LCSW Jennifer Kimball Walter

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Organization

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1330 23rd St S

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LPCC Denage Sauve

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Ste B

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Great Kids Therapy, Ltd.

Organization

Occupational Therapist

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Suite 100

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DR. DDS Patrick J Capp

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West Fargo, ND

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LCSW Erika Louise Lake

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1330 23rd St S

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1437778347

LPCC Megan Tarryn Degenstein

Individual

Mental Health Counselor

1330 23rd St S

Ste B

Fargo, ND

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