Provider Demographics
NPI:1538727441
Name:ST ALEXIUS MEDICAL CENTER
Entity type:Organization
Organization Name:ST ALEXIUS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TESS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-530-3273
Mailing Address - Street 1:900 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4520
Mailing Address - Country:US
Mailing Address - Phone:701-530-3273
Mailing Address - Fax:701-530-6537
Practice Address - Street 1:4315 OTTAWA ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503
Practice Address - Country:US
Practice Address - Phone:701-530-3500
Practice Address - Fax:701-530-3501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST ALEXIUS MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site