Organization
ST. CLOUD HOSPITAL
Active
Parent organization
ST CLOUD HOSPITAL
Other names
CentraCare Kidney Program - Litchfield
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST CLOUD HOSPITAL
Authorized official
MR. MICHAEL A. BLAIR (SR. VICE PRESIDENT AND CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
520 HWY 12 EAST, SUITE 6, LITCHFIELD, MN 55355
(320) 240-7808
(320) 240-7840
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 240-7808
(320) 240-7840
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/03/2007
Last updated
10/10/2019
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