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

Table of content: (NPI 1881688349)

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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