Healthcare Provider Details

I. General information

NPI: 1023078904
Provider Name (Legal Business Name): SIBLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W CHANDLER ST
ARLINGTON MN
55307-2127
US

IV. Provider business mailing address

601 W CHANDLER ST P.O. BOX 620
ARLINGTON MN
55307-2127
US

V. Phone/Fax

Practice location:
  • Phone: 507-964-2271
  • Fax: 507-964-8490
Mailing address:
  • Phone: 507-964-2271
  • Fax: 507-964-8490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMN

VIII. Authorized Official

Name: MICHAEL PHELPS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 952-442-2191