Healthcare Provider Details

I. General information

NPI: 1114951779
Provider Name (Legal Business Name): ST JOSEPH'S HOSPITAL AND HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 06/18/2008
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: 701-456-4378
  • Fax: 701-456-4809
Mailing address:
  • Phone: 701-456-4378
  • Fax: 701-456-4809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number6005A
License Number StateND

VIII. Authorized Official

Name: MS. APRIL L BISHOP
Title or Position: VP/PATIENT SERIVES
Credential:
Phone: 701-456-4000