Organization
MERCY MEDICAL CENTER
Active
Other names
CHI St Alexius Health Williston
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RUARK (VP-OPERATIONAL FINANCE)
(701) 774-7400
Entity
Organization
Contact information
Practice address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Mailing address
1301 15TH AVE W, WILLISTON, ND 58801-3821
(701) 774-7400
(701) 774-7479
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5052A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000142001
BLUE CROSS OF ND
ND
05
—
13671
—
ND
05
—
402272
—
MT
Enumeration date
08/22/2006
Last updated
11/17/2016
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