Provider Demographics
NPI:1669491262
Name:ST JOSEPH'S HOSPITAL AND HEALTH CENTER
Entity Type:Organization
Organization Name:ST JOSEPH'S HOSPITAL AND HEALTH CENTER
Other - Org Name:CHI ST. ALEXIUS HEALTH DICKINSON FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REED
Authorized Official - Middle Name:
Authorized Official - Last Name:REYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-456-4000
Mailing Address - Street 1:95 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:BEACH
Mailing Address - State:ND
Mailing Address - Zip Code:58621-0940
Mailing Address - Country:US
Mailing Address - Phone:701-872-3777
Mailing Address - Fax:
Practice Address - Street 1:95 2ND ST NW
Practice Address - Street 2:
Practice Address - City:BEACH
Practice Address - State:ND
Practice Address - Zip Code:58621-0940
Practice Address - Country:US
Practice Address - Phone:701-872-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH'S HOSPITAL AND HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-18
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5054A261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1460324Medicaid