Healthcare Provider Details

I. General information

NPI: 1912093725
Provider Name (Legal Business Name): ST ANDREWS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 OHMER ST
BOTTINEAU ND
58318-1045
US

IV. Provider business mailing address

316 OHMER ST
BOTTINEAU ND
58318-1045
US

V. Phone/Fax

Practice location:
  • Phone: 701-228-9300
  • Fax: 701-228-9384
Mailing address:
  • Phone: 701-228-9300
  • Fax: 701-228-9384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. JODI L ATKINSON
Title or Position: CEO/PRESIDENT
Credential:
Phone: 701-228-9300