Organization
CENTRACARE HEALTH SYSTEM
Active
Organization
CENTRACARE HEALTH SYSTEM
Active
Other names
CentraCare Health Community Paramedic
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
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 255-5711
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 255-5711
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443985600
—
MN
01
—
6900009424
RR MEDICARE
MN
Enumeration date
10/11/2016
Last updated
04/05/2017
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