Healthcare Provider Details

I. General information

NPI: 1992947956
Provider Name (Legal Business Name): ST JOSEPH'S HOSPITAL AND HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 FAIRWAY ST
DICKINSON ND
58601
US

IV. Provider business mailing address

2500 FAIRWAY ST
DICKINSON ND
58601
US

V. Phone/Fax

Practice location:
  • Phone: 701-456-4000
  • Fax: 701-456-4800
Mailing address:
  • Phone: 701-456-4000
  • Fax: 701-456-4800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number5054A
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number5054
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number5054
License Number StateND

VIII. Authorized Official

Name: JOSEPH LAWRENCE RUARK
Title or Position: VP OPERATIONAL FINANCE
Credential:
Phone: 701-774-7408