1659435105 NPI number — ST. ALEXIUS MEDICAL CENTER

Table of content: (NPI 1659435105)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659435105 NPI number — ST. ALEXIUS MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. ALEXIUS MEDICAL CENTER
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:
GREAT PLAINS REHABILITATION SERVICES
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:
1659435105
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1212 E MAIN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BISMARCK
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58501-4518
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-530-4000
Provider Business Mailing Address Fax Number:
701-530-4001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1212 E MAIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BISMARCK
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58501-4518
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-530-4000
Provider Business Practice Location Address Fax Number:
701-530-4001
Provider Enumeration Date:
12/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MORRIS
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
701-530-7000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BN1400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 7816 . This is a "BC BS" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: MEDICA . This is a "8200734" identifier . This identifiers is of the category "OTHER".
  • Identifier: 03320001 . This is a "BCBS ND CLINIC #" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 76916GR . This is a "BC BS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8200734 . This is a "MEDICA INS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 141797700 . This is a "FEDERAL WORKFORCE SAFETY" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 5600803 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 15-00713-1 . This is a "DEPT OF LABOR" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 55980 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: YP32445A . This is a "TRANSAMERICA OCCI LIFE" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".
  • Identifier: 9150410 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 310990 . This is a "BC BS" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 8200735 . This is a "MEDICA INS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1457725 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9052028 . This is a "WORKFORCE SAFETY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9164400 . This is a "OFFICE OF MEDICAL SERVICE" identifier , issued by the state of ( ND ) . This identifiers is of the category "OTHER".




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