Healthcare Provider Details

I. General information

NPI: 1013082916
Provider Name (Legal Business Name): ERICKSON COMPANIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 NORTH MONROE STREET
MINNEOTA MN
56264
US

IV. Provider business mailing address

700 N MONROE ST. BOX 117
MINNEOTA MN
56264
US

V. Phone/Fax

Practice location:
  • Phone: 507-872-5313
  • Fax: 507-872-5389
Mailing address:
  • Phone: 507-872-5313
  • Fax: 507-872-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number02412
License Number StateMN

VIII. Authorized Official

Name: MS. KATHY JOHNSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 507-872-5302