Centracare Clinic - St Jospeh

LBN: Centracare Clinic
Centracare Clinic - St Jospeh is an health care organization with primary practice located at 1360 Elm Street East Centracare Clinic - St Joseph, St Joseph MN 56374-4106. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty. Centracare Clinic can be contacted via phone (320) 363-7765, or through Blair, Michael A via phone (320) 255-5665.

Contact Information

Primary practice address
1360 Elm Street East Centracare Clinic - St Joseph St Joseph MN 56374-4106
Phone: (320) 363-7765
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Blair, Michael A
Phone: (320) 255-5665

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X Minnesota
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1134121759
LBN Legal business name Centracare Clinic
DBA Doing business as Centracare Clinic - St Jospeh
Authorized official Blair, Michael A
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 12th, 2005
Last updated Jul 21st, 2022 - about 4 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 1134121759 NPPES
Other NA133 PREF ONE
Other NA930 PREF ONE
MEDICAID 990228700 PREF ONE
Other 86D71CE PREF ONE
Other 110964 PREF ONE
Other 35580 PREF ONE
Other 98-01789 PREF ONE

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