Organization
CENTRACARE HEALTH SYSTEM
Active
Other names
CentraCare Emergency Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BLAIR (CFO)
(320) 251-2700
Entity
Organization
Contact information
Practice address
121 LAKE ST N, BIG LAKE, MN 55309-9254
(320) 251-2700
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
341600000X
Ambulance
Primary
—
—
Other
Enumeration date
09/19/2019
Last updated
04/16/2024
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