MEDICARE: SMALL HOLDINGS PA

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	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1245052554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMALL HOLDINGS PA

Provider Business Mailing Address
First Line	:	161 19TH ST S STE 106
Second Line	:
City	:	SARTELL
State	:	MN
Zip	:	56377-2555
Country	:	US
Telephone Number	:	320-252-3376
Fax Number	:	320-288-2701

Provider Business Practice Location Address
First Line	:	161 19TH ST S STE 106
Second Line	:
City	:	SARTELL
State	:	MN
Zip	:	56377-2555
Country	:	US
Telephone Number	:	320-252-3376
Fax Number	:	320-288-2701

Authorized Official
Title or Position	:	MD/OWNER
Name	:	DR. BARRY ALLEN LABINE
Credential	:	MD
Telephone Number	:	320-217-3099

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	09/05/2025

Similar Medicare Providers

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Practice Location Address:

161 19TH ST S STE 101
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1780686592 — MR. BARRY A LABINE MD
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1023639044 — LINDSEY LUKASON
Practice Location Address:

161 19TH ST S STE 101
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1750989059 — JENNIFER MICHELLE SLOAN L.M.T.
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1083343206 — SHAWNEE BROWN
Practice Location Address:

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Directions to “SMALL HOLDINGS PA ” Practice Location

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