Organization
ST CLOUD HOSPITAL
Active
Other names
CentraCare Kidney Program - South St Cloud
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY R KLUGHERZ (VICE PRESIDENT AND CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
30 25TH AVE S, SAINT CLOUD, MN 56301-6285
(320) 251-2700
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7009
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
MN
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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