Provider Demographics
NPI:1225492259
Name:ST. ANDREW'S HOSPITAL
Entity Type:Organization
Organization Name:ST. ANDREW'S HOSPITAL
Other - Org Name:SMP HEALTH - ST. ANDREW'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HUMAN RESOURCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-228-9314
Mailing Address - Street 1:316 OHMER ST
Mailing Address - Street 2:
Mailing Address - City:BOTTINEAU
Mailing Address - State:ND
Mailing Address - Zip Code:58318-1045
Mailing Address - Country:US
Mailing Address - Phone:701-228-9300
Mailing Address - Fax:701-228-9384
Practice Address - Street 1:316 OHMER ST
Practice Address - Street 2:
Practice Address - City:BOTTINEAU
Practice Address - State:ND
Practice Address - Zip Code:58318-1045
Practice Address - Country:US
Practice Address - Phone:701-228-9364
Practice Address - Fax:701-228-9346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SMP HEALTH - ST. ANDREW'S
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-06
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPHAR1823336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND35-02160OtherNABP NCPDP