Provider Demographics
NPI:1902949845
Name:TRINITY HEALTH
Entity Type:Organization
Organization Name:TRINITY HEALTH
Other - Org Name:TCC-WESTERN DAKOTA LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SEEHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-857-5178
Mailing Address - Street 1:1102 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-4233
Mailing Address - Country:US
Mailing Address - Phone:701-572-7711
Mailing Address - Fax:701-572-0566
Practice Address - Street 1:1102 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-4233
Practice Address - Country:US
Practice Address - Phone:701-572-7711
Practice Address - Fax:701-572-0566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND70735OtherBCBS
ND70735OtherBCBS