Provider Demographics
NPI:1881665768
Name:APPLIED MEDICAL, INC
Entity Type:Organization
Organization Name:APPLIED MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:I
Authorized Official - Last Name:HINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L
Authorized Official - Phone:701-255-7920
Mailing Address - Street 1:PO BOX 1834
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58502-1834
Mailing Address - Country:US
Mailing Address - Phone:701-255-7920
Mailing Address - Fax:701-255-7401
Practice Address - Street 1:1139 S. 12TH STREET
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504
Practice Address - Country:US
Practice Address - Phone:701-255-7920
Practice Address - Fax:701-255-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 225X00000X, 235Z00000X
SD0398225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty