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MOOSE LAKE COMMUNITY HOSPITAL DISTRICT NPI 1295804482


NPI Information

NPI: 1295804482
Provider Name: MOOSE LAKE COMMUNITY HOSPITAL DISTRICT

Doing Business As: MERCY HOME HEALTH AGENCY

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 24D1059276

Address:
30 ARROWHEAD LANE
MOOSE LAKE, MN
ZIP 55767
Phone: (218) 485-5506
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MOOSE LAKE COMMUNITY HOSPITAL DISTRICT is a home health in Moose Lake, MN. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. MOOSE LAKE COMMUNITY HOSPITAL DISTRICT NPI is 1295804482. The provider is registered as an organization entity type.
The provider Is Doing Business As Mercy Home Health Agency.

The provider's business location address is:

30 ARROWHEAD LANE
MOOSE LAKE, MN
ZIP 55767
Phone: (218) 485-5506
Fax: (218) 485-5908

The provider's authorized official is Michael J Delfs .
The authorized official title is Chief Executive Officer and has the following contact phone number (218) 485-5858.

The CLIA number assigned to this NPI record is 24D1059276 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/6/2006 and was last updated on 3/25/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health374783MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1315245600MEDICAIDMINNESOTA
2248051MEDICARE OSCAR/CERTIFICATIONMINNESOTA
31757AMEOTHERMINNESOTABLUE CROSS BLUE SHIELD
45900060OTHERMINNESOTAMEDICA CHOICE

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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