Hermantown Valley Elder Care

LBN: Hermantown Valley Elder Care
Hermantown Valley Elder Care is an health care organization with primary practice located at 5140 Wagner Rd , Hermantown MN 55810-2543. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Hermantown Valley Elder Care can be contacted via phone (218) 729-9831, or through Majchrzak, Timothy Russell via phone (218) 729-9831.

Contact Information

Primary practice address
5140 Wagner Rd Hermantown MN 55810-2543
Phone: (218) 729-9831
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Majchrzak, Timothy Russell
Phone: (218) 729-9831

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X 1031815-4-AFC Minnesota

Profile Details

NPI number 1104150044
LBN Legal business name Hermantown Valley Elder Care
DBA Doing business as
Authorized official Majchrzak, Timothy Russell
Entity Organization
Organization subpart 1 No
Enumeration date Sep 24th, 2009
Last updated Sep 24th, 2009 - about 17 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 1104150044 NPPES
Minnesota Other 4980573 MEDICA

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