Provider Demographics
NPI:1679139323
Name:ST ALOISIUS HOSPITAL INC
Entity Type:Organization
Organization Name:ST ALOISIUS HOSPITAL INC
Other - Org Name:ST ALOISIUS MEDICAL CENTER CLINIC - FESSENDEN
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:701-324-4687
Practice Address - Street 1:61 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:FESSENDEN
Practice Address - State:ND
Practice Address - Zip Code:58438-7101
Practice Address - Country:US
Practice Address - Phone:701-324-4651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST ALOISIUS HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-17
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty