1881688349 NPI number — HELD ENTERPRISES OF WEST CENTRAL MN, INC

Table of content: DR. SATHVIK RAMKUMAR NAMBURAR MD (NPI 1750027066)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881688349 NPI number — HELD ENTERPRISES OF WEST CENTRAL MN, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELD ENTERPRISES OF WEST CENTRAL MN, INC
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:
Provider Other Organization Name Type Code:
6
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:
1881688349
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 3RD AVE S
Provider Second Line Business Mailing Address:
PO BOX 437
Provider Business Mailing Address City Name:
COLD SPRING
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56320-2579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-685-8399
Provider Business Mailing Address Fax Number:
320-685-4339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 WILLMAR AVE SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLMAR
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56201-3484
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-235-8957
Provider Business Practice Location Address Fax Number:
320-235-8958
Provider Enumeration Date:
09/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HELD
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
320-229-1742

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 170957 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 101L9HE . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8200333 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8200333 . This is a "SELECT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1032078 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 9150640 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".




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