County of Sargent
Organization Active NPI Public Health or Welfare Agency · Forman, ND
NPI 1255469631 · NPPES record last updated Dec 8, 2023
Key facts
- NPI
- 1255469631
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- COUNTY OF SARGENT
- Practice address
- 316 Main Street
Forman, ND 58032 - Phone
- (701) 724-3725
- Fax
- (701) 724-3296
- NPI assigned
- Feb 28, 2007
- Organization subpart
- No
Authorized official
- Name
- Brenda Kay Peterson
- Title
- Administrator
- Phone
- (701) 724-3725
Corporate family (same tax ID) 1
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 35D0682804 | Sargent County District Health Unit | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071024000131 | ND | Part B Supplier - Public Health/Welfare Agency | 5597851477 | Practice locations: Forman, ND |
National Provider Directory
- Tax ID family
- Sargent County Social Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes | ||
| In Home Supportive Care Agency | 253Z00000X |
Addresses
Primary practice location
316 Main Street
Forman, ND 58032
Mailing address
316 Main Street
Forman, ND 58032
Phone (701) 724-3725
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 57995 | Medicaid | ND |
Other names
- Sargent County District Health Unit
Other providers in Forman, ND
- Forman Drug Inc
- Four Seasons Healthcare Center Inc
- Michele H Gilbertson
- Kari Gilje
- Rosanne Clare Lohman
All providers in Forman, ND · Public Health or Welfare Agency in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.