Provider Demographics
NPI:1609932425
Name:ST. ANDREW'S HOSPITAL
Entity Type:Organization
Organization Name:ST. ANDREW'S HOSPITAL
Other - Org Name:ST. ANDREW'S HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-228-9300
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:
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:701-228-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND4375001OtherMAMC