COUNTRYSIDE IV LOUNGE NPI 1730072075

NPI Information

  • NPI: 1730072075
  • Provider Name: COUNTRYSIDE IV LOUNGE
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 214 S 1ST ST
    MONTEVIDEO, MN
    ZIP 56265
  • Phone: (320) 226-5416

Map and Directions

Get Directions

NPI Details

COUNTRYSIDE IV LOUNGE is a clinic center in Montevideo, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). COUNTRYSIDE IV LOUNGE NPI is 1730072075. The provider is registered as an organization entity type.

The provider's business location address is:

214 S 1ST ST
MONTEVIDEO, MN
ZIP 56265-413
Phone: (320) 226-5416

The provider's authorized official is Wyatt C. Haugen .
The authorized official title is Clinic Owner and has the following contact phone number (320) 226-5416.

The enumeration date for this NPI number is 6/3/2025 and was last updated on 6/3/2025.

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 Number License State Primary
1261QH0100XClinic/CenterHealth ServiceNo
2261QM1300XClinic/CenterMulti-SpecialtyNo
3261QM2500XClinic/CenterMedical SpecialtyNo
4261QP2300XClinic/CenterPrimary CareNo
5261QP3300XClinic/CenterPainNo
6261Q00000XClinic/CenterYes

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: 3/30/2025

NPI Synchronization or Removal

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.

Previous NPI
Next NPI