MEDICARE: LITTLE SISTERS OF THE POOR OF ST PAUL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194705830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE SISTERS OF THE POOR OF ST PAUL

Provider Business Mailing Address
First Line	:	330 EXCHANGE ST S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-2311
Country	:	US
Telephone Number	:	651-227-0336
Fax Number	:	651-227-7321

Provider Business Practice Location Address
First Line	:	330 EXCHANGE ST S
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55102-2311
Country	:	US
Telephone Number	:	651-227-0336
Fax Number	:	651-227-7321

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARY ELIZABETH ANDERSON
Credential	:
Telephone Number	:	651-227-0336

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	10/22/2015

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Directions to “LITTLE SISTERS OF THE POOR OF ST PAUL ” Practice Location

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