Provider Demographics
NPI:1730464108
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 MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
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 1:2500 FAIRWAY ST
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601
Mailing Address - Country:US
Mailing Address - Phone:701-456-4200
Mailing Address - Fax:701-456-4849
Practice Address - Street 1:2500 FAIRWAY ST
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601
Practice Address - Country:US
Practice Address - Phone:701-456-4200
Practice Address - Fax:701-456-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12842Medicaid
ND12842Medicaid