Healthcare Provider Details

I. General information

NPI: 1437424322
Provider Name (Legal Business Name): NORTHFIELD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2012
Last Update Date: 06/30/2016
Certification Date:
Deactivation Date: 05/27/2016
Reactivation Date: 06/30/2016

III. Provider practice location address

321 MAIN ST
ELKO NEW MARKET MN
55054-5461
US

IV. Provider business mailing address

321 MAIN ST
ELKO NEW MARKET MN
55054-5461
US

V. Phone/Fax

Practice location:
  • Phone: 952-461-5200
  • Fax:
Mailing address:
  • Phone: 952-461-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number356145
License Number StateMN

VIII. Authorized Official

Name: TIMOTHY L GRONSETH
Title or Position: CFO
Credential:
Phone: 507-646-1416