Active NPI
Walhalla Community Hospital Association
Doing business as Pembilier Nursing Center
- Custodial Care Facility
- Walhalla, ND
National Provider Identifier
1245441344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Custodial Care Facility
- License
- 8056A
- Legal business name
- WALHALLA COMMUNITY HOSPITAL ASSOCIATION
- Doing business as
- Pembilier Nursing Center
- Practice address
- 500 Delano Ave
Walhalla, ND 58282-4637 - Phone
- (701) 549-3310
- Fax
- (701) 549-3833
- NPI assigned
- May 24, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Debra Jean Fraser
- Title
- Administrator
- Phone
- (701) 549-3310
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Custodial Care Facility | 311Z00000X | 8056A | ND | Primary |
Addresses
Primary practice location
500 Delano Ave
Walhalla, ND 58282-4637
Mailing address
500 Delano Ave
Walhalla, ND 58282-4637
Phone (701) 549-3310
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1313 | Other | ND | BCBS |
| 30736 | Medicaid | ND |
Other names 1
- Pembilier Nursing Center
National Provider Directory
National Provider Directory- Tax ID family
- Pembilier Nursing Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Pembilier Nursing Center
- Skilled Nursing Facility
- Walhalla, ND
- NPI 1770506032
Locations
500 Delano Ave
Walhalla, ND 58282
Phone (701) 549-3310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1245441344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 DELANO AVE",
"city": "WALHALLA",
"state": "ND",
"postal_code": "582824637",
"telephone_number": "701-549-3310",
"fax_number": "701-549-3833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 DELANO AVE",
"city": "WALHALLA",
"state": "ND",
"postal_code": "582824637",
"telephone_number": "701-549-3310",
"fax_number": "701-549-3833"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WALHALLA COMMUNITY HOSPITAL ASSOCIATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-24",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "FRASER",
"authorized_official_first_name": "DEBRA",
"authorized_official_middle_name": "JEAN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "701-549-3310",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": "ND",
"license": "8056A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1313",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30736",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Pembilier Nursing Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Walhalla, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.