Centracare - Plaza Clinic

LBN: Centracare Clinic
Centracare - Plaza Clinic is an health care organization with primary practice located at 1900 Centracare Cir Centracare Clinic Health Plaza, Saint Cloud MN 56303-5000. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Urgent Care, 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) 252-2422, or through Blair, Michael A via phone (320) 255-5665.

Contact Information

Primary practice address
1900 Centracare Cir Centracare Clinic Health Plaza Saint Cloud MN 56303-5000
Phone: (320) 252-2422
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 411086657 Minnesota
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Urgent Care 261QU0200X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1407858020
LBN Legal business name Centracare Clinic
DBA Doing business as Centracare - Plaza Clinic
Authorized official Blair, Michael A
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 12th, 2005
Last updated Nov 19th, 2020 - about 6 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 1407858020 NPPES
Other 498R1CE BCBS
Other 170317 BCBS
Other 35580 BCBS
MEDICAID 052720300 BCBS
Other NA356 BCBS
MEDICAID 052720303 BCBS
Other 98-00211 BCBS

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