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Organization
CENTRACARE CLINIC
Active
Organization
CENTRACARE CLINIC
Active
Other names
CentraCare Urgency Center
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS M FELDHEGE (CFO/TREASURER)
(320) 240-2152
Entity
Organization
Contact information
Practice address
1900 CENTRACARE CIR, SUITE 1450, SAINT CLOUD, MN 56303-5000
(320) 229-4917
Mailing address
1900 CENTRACARE CIR, SUITE 1450, SAINT CLOUD, MN 56303-5000
(320) 229-4917
(320) 229-5180
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052720300
—
MN
05
—
990228700
—
MN
Enumeration date
01/23/2007
Last updated
09/10/2024
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