Healthcare Provider Details

I. General information

NPI: 1013961820
Provider Name (Legal Business Name): ST. ALEXIUS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 5TH AVE W
TURTLE LAKE ND
58575-4324
US

IV. Provider business mailing address

PO BOX 280
TURTLE LAKE ND
58575-0280
US

V. Phone/Fax

Practice location:
  • Phone: 701-448-2331
  • Fax: 701-448-2441
Mailing address:
  • Phone: 701-448-2331
  • Fax: 701-448-2441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number5059
License Number StateND

VIII. Authorized Official

Name: TOD GRAEBER
Title or Position: ADMINISTRATOR
Credential:
Phone: 701-463-6505