Provider Demographics
NPI:1306836598
Name:BRIDGES MEDICAL CENTER
Entity Type:Organization
Organization Name:BRIDGES MEDICAL CENTER
Other - Org Name:ESSENTIAL HEALTH ADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-364-7667
Mailing Address - Street 1:201 9TH STREET WEST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MN
Mailing Address - Zip Code:56510
Mailing Address - Country:US
Mailing Address - Phone:218-784-5000
Mailing Address - Fax:218-784-3753
Practice Address - Street 1:201 9TH ST W
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MN
Practice Address - Zip Code:56510-1243
Practice Address - Country:US
Practice Address - Phone:218-784-5000
Practice Address - Fax:218-784-3753
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESSENTIA HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-27
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN328646282NC0060X, 282NC0060X
MN328541314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN635141700Medicaid
MN610068600Medicaid
MN610118600Medicaid
MN620747200Medicaid
MN24Z313Medicare Oscar/Certification
MN610068600Medicaid
MN241313Medicare Oscar/Certification
MN610118600Medicaid