<Unavail>

LBN: Prairie St Johns
<Unavail> is an health care organization with primary practice located at 510 4Th St S , Fargo ND 58103-1914. The organization recently has only one registered license in Hospitals / Psychiatric Hospital, which is considered as the primary health care specialty. Prairie St Johns can be contacted via phone (701) 476-7200, or through Kenney, Emmet M via phone (701) 476-7882.

Contact Information

Primary practice address
510 4Th St S Fargo ND 58103-1914
Phone: (701) 476-7200
Fax: (701) 476-7261
Website:
Map and Directions
Authorized official contact:
Name: Kenney, Emmet M Doctor of Medicine (MD)
Phone: (701) 476-7882

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Psychiatric Hospital 283Q00000X 5063A North Dakota
Hospitals / Psychiatric Hospital 283Q00000X 1567 Minnesota

Profile Details

NPI number 1417901000
LBN Legal business name Prairie St Johns
DBA Doing business as <Unavail>
Authorized official Kenney, Emmet M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 19th, 2006
Last updated May 22nd, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417901000 NPPES
North Dakota MEDICAID 11778
North Dakota MEDICAID 99725100
North Dakota MEDICAID 099725100

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