Provider Demographics
NPI:1336708536
Name:ST. ALEXIUS MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. ALEXIUS MEDICAL CENTER
Other - Org Name:CHI ST. ALEXIUS HEALTH TURTLE LAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TOD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRAEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-463-6505
Mailing Address - Street 1:PO BOX 280
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 1:220 5TH AVE W
Practice Address - Street 2:
Practice Address - City:TURTLE LAKE
Practice Address - State:ND
Practice Address - Zip Code:58575-4324
Practice Address - Country:US
Practice Address - Phone:701-448-2331
Practice Address - Fax:701-448-2441
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. ALEXIUS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-11
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health