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Organization
CITY OF GRACEVILLE
Active
Organization
CITY OF GRACEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BAUER (CITY OFFICE)
(320) 748-7911
Entity
Organization
Contact information
Practice address
415 STUDDART AVENUE, GRACEVILLE, MN 56240-0231
(320) 748-7911
Mailing address
415 STUDDART AVE, GRACEVILLE, MN 56240-5002
(320) 748-7911
(320) 748-7338
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030722022
PRIME WEST
MN
01
—
49110GR
BCBSMN
MN
05
—
534868400
—
MN
Enumeration date
10/23/2006
Last updated
03/04/2011
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