1578557021 NPI number — HELD ENTERPRISES OF GREATER ST CLOUD, INC

Table of content: (NPI 1578557021)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578557021 NPI number — HELD ENTERPRISES OF GREATER ST CLOUD, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELD ENTERPRISES OF GREATER ST CLOUD, 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:
1578557021
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2025
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:
56320-2580
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:
154 19TH STREET SOUTH
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SARTELL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56377-2153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-229-1742
Provider Business Practice Location Address Fax Number:
320-229-1671
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: 160013 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8200179 . This is a "SELECT CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 066673400 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 75486 . This is a "HEALTHPARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 25D91GR . This is a "BLUECROSS&BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 030824007 . This is a "PRIMEWEST" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1025655 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 8200179 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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