Provider Demographics
NPI:1558423665
Name:CHRISTIAN UNITY HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:CHRISTIAN UNITY HOSPITAL CORPORATION
Other - Org Name:GRAFTON FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-352-1620
Mailing Address - Street 1:164 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1826
Mailing Address - Country:US
Mailing Address - Phone:701-352-1620
Mailing Address - Fax:701-352-1671
Practice Address - Street 1:164 W 13TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1826
Practice Address - Country:US
Practice Address - Phone:701-352-1620
Practice Address - Fax:701-352-1671
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIAN UNITY HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-14
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDN6368OtherMEDICARE B
MNC05922OtherWPS HEALTH INSURANCE
MNC05922OtherWPS HEALTH INSURANCE