ST. CLOUD HOSPITAL NPI 1891966701

NPI Information

NPI: 1891966701
Provider Name: ST. CLOUD HOSPITAL

Doing Business As: CENTRACARE KIDNEY PROGRAM - PERITONEAL DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2035 15TH ST N
SUITE 210
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 251-2700
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ST. CLOUD HOSPITAL is an end-stage renal disease (esrd) treatment clinic center in Saint Cloud, MN. ST. CLOUD HOSPITAL NPI is 1891966701. The provider is registered as an organization entity type.
The provider Is Doing Business As Centracare Kidney Program - Peritoneal Dialysis.

The provider's business location address is:

2035 15TH ST N
SUITE 210
SAINT CLOUD, MN
ZIP 56303-738
Phone: (320) 251-2700
Fax: (320) 656-7009

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

The enumeration date for this NPI number is 3/19/2008 and was last updated on 10/10/2019.

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	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	331506	MINNESOTA	Yes

What is NPI?

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

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