Organization
CENTRACARE CLINIC
Active
Parent organization
CENTRACARE CLINIC
Other names
CentraCare - Clearwater Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRACARE CLINIC
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
615 NELSON DRIVE, PO BOX 217, CLEARWATER, MN 55320
(320) 558-2293
(320) 685-4020
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
MN
Other
Enumeration date
07/12/2017
Last updated
11/19/2020
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