# CITY OF SAUK CENTRE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285665794
- **Authorized official:** MRS. DIANE L TALLACKSON (BILLING MANGER)
- **Authorized official phone:** (651) 653-2201

## Contact information

- **Practice address:** 320 SOUTH OAK STREET, SAUK CENTRE, MN 56378
- **Practice address phone:** (651) 653-2201
- **Practice address fax:** (651) 653-2213
- **Mailing address:** 320 SOUTH OAK STREET, SAUK CENTRE, MN 56378
- **Mailing address phone:** (651) 653-2201
- **Mailing address fax:** (651) 653-2213

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 04/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 55335SA | BLUE CROSS BLUE SHIELD | MN |
| 01 | — | 590012896 | RAILROAD MEDICARE | MN |
| 05 | — | 774867100 | — | MN |