Provider Demographics
NPI:1164424305
Name:DOUGLAS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:DOUGLAS COUNTY HOSPITAL
Other - Org Name:ALOMERE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAAGENES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-762-6021
Mailing Address - Street 1:111 17TH AVE E
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-3703
Mailing Address - Country:US
Mailing Address - Phone:320-762-1511
Mailing Address - Fax:320-762-6101
Practice Address - Street 1:111 17TH AVE E
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-3703
Practice Address - Country:US
Practice Address - Phone:320-762-1511
Practice Address - Fax:320-762-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN300101OtherUCARE
MN61128DOOtherBLUE CROSS BLUE SHIELD PHYS FEES
MN2M580DOOtherBLUE CROSS BLUE SHIELD MHU
MN216114537OtherPRIME WEST
NDN715449OtherMEDICARE PTAN
MN1517HDOOtherBLUE CROSS/BLUE SHIELD
MN60004DOOtherBLUE CROSS BLUE SHIELD CRNA
MN036345600Medicaid
MN1517HDOOtherBLUE CROSS/BLUE SHIELD