Healthcare Provider Details

I. General information

NPI: 1306832795
Provider Name (Legal Business Name): MADISON HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 08/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 2ND AVE
MADISON MN
56256-1006
US

IV. Provider business mailing address

900 2ND AVE
MADISON MN
56256-1006
US

V. Phone/Fax

Practice location:
  • Phone: 320-598-7536
  • Fax: 320-598-3940
Mailing address:
  • Phone: 320-598-7536
  • Fax: 320-598-3940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number327711
License Number StateMN

VIII. Authorized Official

Name: MRS. CAROL M BORGERSON
Title or Position: CFO
Credential:
Phone: 320-698-7152