1255363438 NPI number — CUYUNA REGIONAL MEDICAL CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255363438 NPI number — CUYUNA REGIONAL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CUYUNA REGIONAL MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CUYUNA REGIONAL MEDICAL CENTER HOME HEALTH, PALLIATIVE AND HOSPICE CAR
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255363438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 HEARTWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CROSBY
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56441-5601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
218-546-7000
Provider Business Mailing Address Fax Number:
218-546-4645

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 HEARTWOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CROSBY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56441-5601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-546-7000
Provider Business Practice Location Address Fax Number:
218-546-4645
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BERG
Authorized Official First Name:
KATIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
218-546-7000

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  329842 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251G00000X , with the licence number: 329842 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1598ACU . This is a "BCBS HOMECARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 124184 . This is a "UCARE HOMECARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 247171 . This is a "MEDICARE HOME CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5025389 . This is a "MEDICA CHOICE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 241537 . This is a "MEDICARE HOSPICE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5000069 . This is a "MEDICA PRIMARY" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5900048 . This is a "MEDICA HOMECARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 01012762 . This is a "PREFERRED ONE HOMECARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1598ACU . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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