Organization
ST. CLOUD HOSPITAL
Active
Other names
CentraCare Kidney Program - Olivia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A. BLAIR (SR. VICE PRESIDENT AND CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
600 E PARK AVE, OLIVIA, MN 56277-1370
(320) 251-2700
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/12/2016
Last updated
09/10/2024
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