Provider Demographics
NPI:1639296007
Name:ST ALOISIUS HOSPITAL INC
Entity Type:Organization
Organization Name:ST ALOISIUS HOSPITAL INC
Other - Org Name:ST ALOISIUS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-324-4651
Mailing Address - Street 1:325 BREWSTER ST E
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:ND
Mailing Address - Zip Code:58341-1653
Mailing Address - Country:US
Mailing Address - Phone:701-324-4651
Mailing Address - Fax:170-132-4687
Practice Address - Street 1:325 BREWSTER ST E
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:ND
Practice Address - Zip Code:58341-1653
Practice Address - Country:US
Practice Address - Phone:701-324-4651
Practice Address - Fax:170-132-4687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST ALOISIUS HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-23
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1454594Medicaid
2857OtherBLUE CROSS BLUE SHIELD
35-Z327OtherMEDICARE PTAN
ND1454594Medicaid