Healthcare Provider Details

I. General information

NPI: 1003886763
Provider Name (Legal Business Name): GRANITE FALLS MUNICIPAL HOSPITAL AND MANOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 JORDAN DR
GRANITE FALLS MN
56241-1798
US

IV. Provider business mailing address

250 JORDAN DR
GRANITE FALLS MN
56241-1798
US

V. Phone/Fax

Practice location:
  • Phone: 320-564-6298
  • Fax:
Mailing address:
  • Phone: 320-564-6298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number8828655
License Number StateMN

VIII. Authorized Official

Name: GEORGE J GERLACH
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 320-564-3111