CENTRACARE CLINIC NPI 1134121759

NPI Information

NPI: 1134121759
Provider Name: CENTRACARE CLINIC
Classification: Clinic/Center - 261QM1300X
Specialization: Multi-Specialty
Entity Type: Organization
:
CLIA Number: 24D0406035
Address: 1360 ELM STREET EAST
CENTRACARE CLINIC - ST JOSEPH
ST JOSEPH, MN
ZIP 56374
Phone: (320) 363-7765

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NPI Details

CENTRACARE CLINIC is a multi-specialty clinic center in St Joseph, MN. CENTRACARE CLINIC NPI is 1134121759. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1360 ELM STREET EAST
CENTRACARE CLINIC - ST JOSEPH
ST JOSEPH, MN
ZIP 56374-106
Phone: (320) 363-7765

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 24D0406035 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/12/2005 and was last updated on 6/23/2025.

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		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	98-01789	OTHER		MEDICA
2	NA930	OTHER	MINNESOTA	PREF ONE
3	NA133	OTHER		PREF ONE
4	110964	OTHER		UCARE
5	86D71CE	OTHER		BCBS
6	35580	OTHER		HEALTH PARTNERS
7	990228700	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: 11/21/2025

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