Provider Demographics
NPI:1659549947
Name:ST. ALEXIUS MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. ALEXIUS MEDICAL CENTER
Other - Org Name:PHYSICAL THERAPY WASHBURN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-448-2331
Mailing Address - Street 1:220 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:TURTLE LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58575-0280
Mailing Address - Country:US
Mailing Address - Phone:701-448-2331
Mailing Address - Fax:701-448-2441
Practice Address - Street 1:1177 BORDER LANE
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:ND
Practice Address - Zip Code:58577-0447
Practice Address - Country:US
Practice Address - Phone:701-462-3396
Practice Address - Fax:701-462-3422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty