Healthcare Provider Details

I. General information

NPI: 1740240225
Provider Name (Legal Business Name): SIBLEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WEST CHANDLER STREET
ARLINGTON MN
55307-0620
US

IV. Provider business mailing address

601 WEST CHANDLER STREET P.O. BOX 620
ARLINGTON MN
55307-0620
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 Code282NC0060X
TaxonomyCritical Access Hospital
License Number241311
License Number StateMN

VIII. Authorized Official

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