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Organization
SEMCAC
Active
Organization
SEMCAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY ERICKSON (EXECUTIVE DIRECTOR)
(507) 864-7741
Entity
Organization
Contact information
Practice address
204 ELM ST S, RUSHFORD, MN 55971-0549
(507) 864-7741
(507) 864-2440
Mailing address
204 ELM ST S, PO BOX 549, RUSHFORD, MN 55971-0549
(507) 864-7741
(507) 864-2440
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
124727
UCARE PROVIDER NUMBER
MN
Enumeration date
04/27/2007
Last updated
08/22/2020
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