Provider Demographics
NPI:1659435105
Name:ST. ALEXIUS MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. ALEXIUS MEDICAL CENTER
Other - Org Name:GREAT PLAINS REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-530-7000
Mailing Address - Street 1:1212 E MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4518
Mailing Address - Country:US
Mailing Address - Phone:701-530-4000
Mailing Address - Fax:701-530-4001
Practice Address - Street 1:1212 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4518
Practice Address - Country:US
Practice Address - Phone:701-530-4000
Practice Address - Fax:701-530-4001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC HEALTH INITIATIVES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-20
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND7816OtherBC BS
MEDICAOther8200734
ND03320001OtherBCBS ND CLINIC #
MN76916GROtherBC BS
8200734OtherMEDICA INS
ND141797700OtherFEDERAL WORKFORCE SAFETY
MT5600803Medicaid
MT15-00713-1OtherDEPT OF LABOR
ND55980Medicaid
NDYP32445AOtherTRANSAMERICA OCCI LIFE
SD9150410Medicaid
MT310990OtherBC BS
8200735OtherMEDICA INS
ND1457725Medicaid
WA9052028OtherWORKFORCE SAFETY
ND9164400OtherOFFICE OF MEDICAL SERVICE
ND0356230001Medicare NSC
MEDICAOther8200734