Healthcare Provider Details

I. General information

NPI: 1437210317
Provider Name (Legal Business Name): ST. ALEXIUS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 E MAIN AVE
BISMARCK ND
58501
US

IV. Provider business mailing address

1212 E MAIN AVE
BISMARCK ND
58502
US

V. Phone/Fax

Practice location:
  • Phone: 701-530-4500
  • Fax: 701-530-4572
Mailing address:
  • Phone: 701-530-4500
  • Fax: 701-530-4572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4037
License Number StateND

VIII. Authorized Official

Name: PAUL MORRIS
Title or Position: CFO
Credential:
Phone: 701-530-7000