ST. MARY'S MEDICAL CENTER NPI 1225089634

NPI Information

NPI: 1225089634
Provider Name: ST. MARY'S MEDICAL CENTER

Doing Business As: ESSENTIA HEALTH ST. MARY'S HOSPICE & PALLIATIVE CARE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
407 E 4TH ST
DULUTH, MN
ZIP 55805
Phone: (218) 786-4020
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ST. MARY'S MEDICAL CENTER is a hospice care community based in Duluth, MN. ST. MARY'S MEDICAL CENTER NPI is 1225089634. The provider is registered as an organization entity type.
The provider Is Doing Business As Essentia Health St. Mary's Hospice & Palliative Care.

The provider's business location address is:

407 E 4TH ST
DULUTH, MN
ZIP 55805-282
Phone: (218) 786-4020
Fax: (218) 786-4223

The provider's authorized official is Kevin Boren .
The authorized official title is Vp Of Finance and has the following contact phone number (218) 786-1009.

The CLIA number assigned to this NPI record is 24D1056896 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/12/2006 and was last updated on 2/28/2024.

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	251G00000X	Hospice Care, Community Based		02562	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	5025446	OTHER	MINNESOTA	MEDICA
2	7L61ST	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD
3	1225089634	MEDICAID	WISCONSIN
4	1225089634	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: 4/28/2024

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