- Enrollment id
- O20030519000000
- Enrollment state
- ND
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1386638179
- Multiple npi flag
- N
- Ccn
- 351510
- Associate id
- 2264341031
- Organization name
- LUTHERAN CHARITY ASSOCIATION
- Doing business as name
- JAMESTOWN REGIONAL MEDICAL CENTER
- Incorporation date
- 1927-05-27
- Incorporation state
- ND
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2422 20TH ST SW
- City
- JAMESTOWN
- State
- ND
- Zip code
- 584016201