Provider Demographics
NPI:1356537419
Name:ST JOSEPH'S HOSPITAL & HEALTH CENTER-MEDQUEST
Entity type:Organization
Organization Name:ST JOSEPH'S HOSPITAL & HEALTH CENTER-MEDQUEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:URBANEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-456-4364
Mailing Address - Street 1:584 12TH ST W
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-3509
Mailing Address - Country:US
Mailing Address - Phone:701-456-4364
Mailing Address - Fax:
Practice Address - Street 1:584 12TH ST W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-3509
Practice Address - Country:US
Practice Address - Phone:701-456-4364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND70506332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND70506OtherBCBS OF ND