Provider Demographics
NPI:1124051230
Name:ST JOSEPHS HOSPITAL AND HEALTH CENTER
Entity type:Organization
Organization Name:ST JOSEPHS HOSPITAL AND HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:REED
Authorized Official - Middle Name:E
Authorized Official - Last Name:REYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-456-4271
Mailing Address - Street 1:584 12TH STREET WEST
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-3509
Mailing Address - Country:US
Mailing Address - Phone:701-456-4364
Mailing Address - Fax:701-456-4642
Practice Address - Street 1:584 12TH ST W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:ND
Practice Address - Zip Code:58601-3509
Practice Address - Country:US
Practice Address - Phone:701-456-4364
Practice Address - Fax:701-456-4642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5054A332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND0434250001Medicare NSC