ST. CLOUD HOSPITAL NPI 1710936216

NPI Information

NPI: 1710936216
Provider Name: ST. CLOUD HOSPITAL

Doing Business As: CENTRACARE KIDNEY PROGRAM - LITTLE FALLS DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
808 3RD ST SE
LITTLE FALLS, MN
ZIP 56345
Phone: (320) 632-1191
Get Directions

ST. CLOUD HOSPITAL is an end-stage renal disease (esrd) treatment clinic center in Little Falls, MN. ST. CLOUD HOSPITAL NPI is 1710936216. The provider is registered as an organization entity type.
The provider Is Doing Business As Centracare Kidney Program - Little Falls Dialysis.

The provider's business location address is:

808 3RD ST SE
LITTLE FALLS, MN
ZIP 56345
Phone: (320) 632-1191
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 CLIA number assigned to this NPI record is 24D0406127 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2006 and was last updated on 10/8/2019.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	883747300	MEDICAID	MINNESOTA

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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