Healthcare Provider Details

I. General information

NPI: 1003903840
Provider Name (Legal Business Name): GOOD SAMARITAN HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 10TH ST SE APT 36
RUGBY ND
58368-2564
US

IV. Provider business mailing address

2975 HIGHWAY 2 E
RUGBY ND
58368-7801
US

V. Phone/Fax

Practice location:
  • Phone: 701-771-7208
  • Fax:
Mailing address:
  • Phone: 701-776-5455
  • Fax: 701-776-5448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number6013A
License Number StateND

VIII. Authorized Official

Name: ERIK T CHRISTENSON
Title or Position: CEO
Credential:
Phone: 701-776-5261