1538320932 NPI number — MR. SHAROLD EDWIN OSTER LIC ADDICTION COUNS

Table of content: MR. SHAROLD EDWIN OSTER LIC ADDICTION COUNS (NPI 1538320932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538320932 NPI number — MR. SHAROLD EDWIN OSTER LIC ADDICTION COUNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSTER
Provider First Name:
SHAROLD
Provider Middle Name:
EDWIN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LIC ADDICTION COUNS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538320932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 8TH AVE NE
Provider Second Line Business Mailing Address:
HAZEN MEMORIAL HOSPITAL ASSOC
Provider Business Mailing Address City Name:
HAZEN
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-748-2225
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 8TH AVE NE
Provider Second Line Business Practice Location Address:
5 SAKAKAWEA MEDICAL CENTER
Provider Business Practice Location Address City Name:
HAZEN
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-748-3888
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  1262 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)