Provider Demographics
NPI:1720829583
Name:RURAL SURGICAL SOLUTIONS, PLLC
Entity type:Organization
Organization Name:RURAL SURGICAL SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-208-1375
Mailing Address - Street 1:PO BOX 393
Mailing Address - Street 2:
Mailing Address - City:VELVA
Mailing Address - State:ND
Mailing Address - Zip Code:58790-0393
Mailing Address - Country:US
Mailing Address - Phone:701-208-1375
Mailing Address - Fax:
Practice Address - Street 1:1002 18TH AVE SE
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701
Practice Address - Country:US
Practice Address - Phone:701-852-6143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical