MILLE LACS HEALTH SYSTEM NPI 1326200411

NPI Information

NPI: 1326200411
Provider Name: MILLE LACS HEALTH SYSTEM

Doing Business As: MILLE LACS FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
26362 370TH AVE
HILLMAN, MN
ZIP 56338
Phone: (320) 277-3682
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MILLE LACS HEALTH SYSTEM is a rural health clinic center in Hillman, MN. MILLE LACS HEALTH SYSTEM NPI is 1326200411. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mille Lacs Family Health Center.

The provider's business location address is:

26362 370TH AVE
HILLMAN, MN
ZIP 56338-349
Phone: (320) 277-3682
Fax: (320) 277-3372

The provider's authorized official is John W Unzen .
The authorized official title is Cfo and has the following contact phone number (320) 532-2581.

The CLIA number assigned to this NPI record is 24D0880659 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2008 and was last updated on 4/26/2017.

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	Primary
1	207Q00000X	Family Medicine		No
2	363AM0700X	Physician Assistant	Medical	No
3	261QR1300X	Clinic/Center	Rural Health	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	115808	OTHER	MINNESOTA	UCARE MINNESOTA
2	C02122	MEDICARE OSCAR/CERTIFICATION	MINNESOTA
3	243434	MEDICARE OSCAR/CERTIFICATION	MINNESOTA
4	630994100	MEDICAID	MINNESOTA
5	33523MI	OTHER	MINNESOTA	BLUE CROSS BLUE SHIELD 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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