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Organization
CITY OF SAUK CENTRE
Active
Organization
CITY OF SAUK CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE L TALLACKSON (BILLING MANGER)
(651) 653-2201
Entity
Organization
Contact information
Practice address
320 SOUTH OAK STREET, SAUK CENTRE, MN 56378
(651) 653-2201
(651) 653-2213
Mailing address
320 SOUTH OAK STREET, SAUK CENTRE, MN 56378
(651) 653-2201
(651) 653-2213
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55335SA
BLUE CROSS BLUE SHIELD
MN
01
—
590012896
RAILROAD MEDICARE
MN
05
—
774867100
—
MN
Enumeration date
07/05/2006
Last updated
04/22/2008
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