1235294513 NPI number — MONTANA-DAKOTA UTILITIES CO., A DIVISION OF MDU RESOURCES GROUP INC.

Table of content: (NPI 1235294513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235294513 NPI number — MONTANA-DAKOTA UTILITIES CO., A DIVISION OF MDU RESOURCES GROUP INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONTANA-DAKOTA UTILITIES CO., A DIVISION OF MDU RESOURCES GROUP INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MONTANA-DAKOTA UTILITIES CO.
Provider Other Organization Name Type Code:
3
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:
1235294513
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 N 4TH ST
Provider Second Line Business Mailing Address:
ATTN DAWN WETZSTEIN
Provider Business Mailing Address City Name:
BISMARCK
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58501-4092
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-222-7900
Provider Business Mailing Address Fax Number:
701-222-7886

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 N 4TH ST
Provider Second Line Business Practice Location Address:
ATTN DAWN WETZSTEIN
Provider Business Practice Location Address City Name:
BISMARCK
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58501-4092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-222-7900
Provider Business Practice Location Address Fax Number:
701-222-7886
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WETZSTEIN
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRODUCTS & SERVICES COORDINATOR
Authorized Official Telephone Number:
701-222-7919

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0800632 . This is a "INDIVIDUAL PROVIDER" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 33046 . This is a "QUALIFIED SERVICE PROVIDE" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 9560460 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




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