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GRAND PORTAGE HEALTH SERVICE NPI 1659436954


NPI Information

NPI: 1659436954
Provider Name: GRAND PORTAGE HEALTH SERVICE
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 24D0692831

Address:
62 UPPER ROAD
GRAND PORTAGE, MN
ZIP 55605
Phone: (218) 475-2235
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GRAND PORTAGE HEALTH SERVICE is a health service clinic center in Grand Portage, MN. GRAND PORTAGE HEALTH SERVICE NPI is 1659436954. The provider is registered as an organization entity type.

The provider's business location address is:

62 UPPER ROAD
GRAND PORTAGE, MN
ZIP 55605-428
Phone: (218) 475-2235
Fax: (218) 475-2261

The provider's authorized official is Grace Elizabeth Bushard .
The authorized official title is Health Director and has the following contact phone number (218) 475-2235.

The CLIA number assigned to this NPI record is 24D0692831 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 8/22/2020.


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
1261QH0100XClinic/CenterHealth ServiceYes

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

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.