Healthcare Provider Details
I. General information
NPI: 1467473827
Provider Name (Legal Business Name): MEDICAL ARTS OUTPATIENT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2006
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
530 20TH AVE SW
MINOT ND
58701-6437
US
IV. Provider business mailing address
530 20TH AVE SW
MINOT ND
58701-6437
US
V. Phone/Fax
- Phone: 701-857-7370
- Fax: 701-857-7419
- Phone: 701-857-7370
- Fax: 701-857-7419
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 56729 |
| Identifier Type | MEDICAID |
| Identifier State | ND |
| Identifier Issuer | |
VIII. Authorized Official
Name:
JOHN
M
KUTCH
Title or Position: PRESIDENT & CEO
Credential:
Phone: 701-418-8000