Healthcare Provider Details

I. General information

NPI: 1225058217
Provider Name (Legal Business Name): ST JOSEPHS HOSPITAL AND HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 7TH ST W
DICKINSON ND
58601-3949
US

IV. Provider business mailing address

30 7TH ST W
DICKINSON ND
58601-4335
US

V. Phone/Fax

Practice location:
  • Phone: 701-483-2973
  • Fax: 701-483-2983
Mailing address:
  • Phone: 701-456-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number5054A
License Number StateND

VIII. Authorized Official

Name: APRIL BISHOP
Title or Position: INTERIM CEO
Credential:
Phone: 701-456-4000