Provider Demographics
NPI:1083775688
Name:CARRINGTON HEALTH CENTER
Entity Type:Organization
Organization Name:CARRINGTON HEALTH CENTER
Other - Org Name:CHI ST. ALEXIUS HEALTH CARRINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OPERATIONAL FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-237-8064
Mailing Address - Street 1:800 4TH ST N
Mailing Address - Street 2:PO BOX 461
Mailing Address - City:CARRINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58421-1217
Mailing Address - Country:US
Mailing Address - Phone:701-352-3141
Mailing Address - Fax:701-652-3595
Practice Address - Street 1:840 4TH ST N
Practice Address - Street 2:
Practice Address - City:CARRINGTON
Practice Address - State:ND
Practice Address - Zip Code:58421-0461
Practice Address - Country:US
Practice Address - Phone:701-652-3414
Practice Address - Fax:701-652-3595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND8904OtherBLUE CROSS BLUE SHIELD ND
ND50779Medicaid
ND50779Medicaid