Healthcare Provider Details

I. General information

NPI: 1821084658
Provider Name (Legal Business Name): PIPESTONE COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 4TH AVE SW
PIPESTONE MN
56164-1890
US

IV. Provider business mailing address

916 4TH AVE SW
PIPESTONE MN
56164-1890
US

V. Phone/Fax

Practice location:
  • Phone: 507-825-5811
  • Fax: 507-825-5733
Mailing address:
  • Phone: 507-825-5811
  • Fax: 507-825-5733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number326877
License Number StateMN

VIII. Authorized Official

Name: MR. BRADLEY D BURRIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 507-825-5811