CENTRACARE CLINIC NPI 1689196339

NPI Information

NPI: 1689196339
Provider Name: CENTRACARE CLINIC

Doing Business As: CENTRACARE - ST CLOUD MEDICAL GROUP NORTH

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
251 COUNTY ROAD 120
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 202-8949
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CENTRACARE CLINIC is a primary care clinic center in Saint Cloud, MN. CENTRACARE CLINIC NPI is 1689196339. The provider is registered as an organization entity type.
The provider Is Doing Business As Centracare - St Cloud Medical Group North.

The provider's business location address is:

251 COUNTY ROAD 120
SAINT CLOUD, MN
ZIP 56303-872
Phone: (320) 202-8949
Fax: (320) 257-1733

The provider's authorized official is Michael A Blair .
The authorized official title is Sr Vp & Cfo and has the following contact phone number (320) 255-5665.

The CLIA number assigned to this NPI record is 24D0907491 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/14/2017 and was last updated on 11/19/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care		MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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