Healthcare Provider Details

I. General information

NPI: 1457488975
Provider Name (Legal Business Name): UNION HOSPITAL SOCIETY OF MAYVILLE ND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 6TH AVENUE SE
MAYVILLE ND
58257
US

IV. Provider business mailing address

42 6TH AVENUE SE
MAYVILLE ND
58257
US

V. Phone/Fax

Practice location:
  • Phone: 701-788-3800
  • Fax: 701-788-2145
Mailing address:
  • Phone: 701-788-3800
  • Fax: 701-788-2145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number5034P
License Number StateND

VIII. Authorized Official

Name: ROGER A BAIER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 701-788-3800