Organization
HIAWATHA MEDICAL INC
Active
Other names
Hiawatha Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN L STAATS (CFO)
(651) 388-2223
Entity
Organization
Contact information
Practice address
4920 MOUNDVIEW DR, SUITE B, RED WING, MN 55066-1100
(651) 388-2223
Mailing address
4920 MOUNDVIEW DR, SUITE B, RED WING, MN 55066-1100
(651) 388-2223
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
331637
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007436
PREFFERED ONE PROVIDER #
MN
01
—
125651
UCARE PROVIDER #
MN
05
—
41533600
—
WI
01
—
59-00045
MEDICA INS PROVIDER #
MN
01
—
9266HI
BCBCMN PROVIDER #
MN
Enumeration date
07/03/2006
Last updated
08/22/2020
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