Healthcare Provider Details

I. General information

NPI: 1578105219
Provider Name (Legal Business Name): CARRIS HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S SIBLEY AVE
LITCHFIELD MN
55355-3030
US

IV. Provider business mailing address

301 BECKER AVE SW
WILLMAR MN
56201-3302
US

V. Phone/Fax

Practice location:
  • Phone: 320-693-3233
  • Fax:
Mailing address:
  • Phone: 320-235-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL BLAIR
Title or Position: CFO
Credential:
Phone: 320-255-5665