CENTRACARE CLINIC NPI 1043212665

NPI Information

NPI: 1043212665
Provider Name: CENTRACARE CLINIC

Doing Business As: CENTRACARE - RIVER CAMPUS CLINIC

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1200 SIXTH AVE NO
CENTRACARE CLINIC
ST CLOUD, MN
ZIP 56303
Phone: (320) 252-5131
Get Directions

CENTRACARE CLINIC is a multi-specialty clinic center in St Cloud, MN. CENTRACARE CLINIC NPI is 1043212665. The provider is registered as an organization entity type.
The provider Is Doing Business As Centracare - River Campus Clinic.

The provider's business location address is:

1200 SIXTH AVE NO
CENTRACARE CLINIC
ST CLOUD, MN
ZIP 56303-735
Phone: (320) 252-5131
Fax: (320) 240-2118

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 enumeration date for this NPI number is 8/12/2005 and was last updated on 7/21/2022.

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 State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	MINNESOTA	No
2	332B00000X	Durable Medical Equipment & Medical Supplies			No
3	261QM1300X	Clinic/Center	Multi-Specialty	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	N002912	OTHER		CHAMPUS
2	110890	OTHER		U CARE
3	990228700	MEDICAID	MINNESOTA
4	35580	OTHER		HEALTH PARTNERS
5	6D053CE	OTHER		BLUE CROSS BLUE SHIELD
6	98-04122	OTHER		MEDICA

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »