Healthcare Provider Details

I. General information

NPI: 1861414518
Provider Name (Legal Business Name): CUYUNA REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 JORDAN LANE
LONGVILLE MN
56655
US

IV. Provider business mailing address

320 EAST MAIN STREET
CROSBY MN
56441
US

V. Phone/Fax

Practice location:
  • Phone: 218-363-3300
  • Fax: 218-363-2233
Mailing address:
  • Phone: 218-546-7000
  • Fax: 218-363-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATIE BERG
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 218-546-7000