| Organization Name: | FAIRLIGHT MEDICAL CENTER |
| NPI Number: | 1104079409 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY MARIE REIGER (BILLING/INSURANCE CLERK) |
| Mailing Address: | 3 4th St E Suite 101 Williston |
| State: | ND US |
| Postal Code: | 588015350 |
| Phone Number: | 7015776337 |
| Fax Number: | 7015774867 |
| NPI Enumeration Date: | 10/30/2008 |
| NPI Last Update Date: | 10/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | 6414 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |