DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: ST MARYS REGIONAL HEALTH CENTER

MEDICARE: ST MARYS REGIONAL HEALTH CENTER
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
1314000000XSkilled Nursing Facility328815MN
2314000000XSkilled Nursing Facility354804MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21607EMAOTHERMNBLUE CROSS BLUE SHIELD MN
38Y02MAOTHERMNBLUE CROSS BLUE SHIELD
47122625OTHERMNMEDICA
58Y02MAOTHERBLUE CROSS BLUE SHIE

General Provider Information

NPI Number : 1578553160
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST MARYS REGIONAL HEALTH CENTER
Provider Business Mailing Address
First Line : 1040 LINCOLN AVE
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-3409
Country : US
Telephone Number : 218-847-0820
Fax Number : 218-844-0780
Provider Business Practice Location Address
First Line : 1040 LINCOLN AVE
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-3409
Country : US
Telephone Number : 218-847-0820
Fax Number : 218-844-0780
Authorized Official
Title or Position : COO
Name : ALAN JAMES HURLEY
Credential :
Telephone Number : 979-820-4247
Provider Enumeration Date : 10/25/2005
Last Update Date : 03/01/2024

Similar Medicare Providers

1063414084 — JANELL KJOS FNP, BC
Practice Location Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
56501-3409
Practice Phone: 218-847-5611
Practice Fax: 218-847-0881
1689662983 — DR. RICHARD EMIL MARTIN MD
Practice Location Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
56501-3409
Practice Phone: 218-847-5611
Practice Fax: 218-847-0891
1588653331 — DR. LARRY DEAN KOBRIGER MD
Practice Location Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
56501-3409
Practice Phone: 218-847-5611
Practice Fax: 218-847-0891
1134118250 — ST MARY'S REGIONAL HEALTH CENTER
Practice Location Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
56501-3409
Practice Phone: 218-847-5611
Practice Fax: 218-847-0881
1447240304 — ST MARYS REGIONAL HEALTH CENTER
Practice Location Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
56501-3409
Practice Phone: 218-847-5611
Practice Fax: 218-847-0881
1811965775 — MANUEL R. MORAN M.D.
Practice Location Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
56501-3409
Practice Phone: 218-847-5611
Practice Fax:

Directions to “ST MARYS REGIONAL HEALTH CENTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.