Healthcare Provider Details

I. General information

NPI: 1053334847
Provider Name (Legal Business Name): ST JOSEPHS HOSPITAL & HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 7TH ST W
DICKINSON ND
58601-4335
US

IV. Provider business mailing address

30 7TH ST W
DICKINSON ND
58601-4335
US

V. Phone/Fax

Practice location:
  • Phone: 701-456-4308
  • Fax: 701-456-4804
Mailing address:
  • Phone: 701-456-4308
  • Fax: 701-456-4804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5054A
License Number StateND

VIII. Authorized Official

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