Healthcare Provider Details

I. General information

NPI: 1114469004
Provider Name (Legal Business Name): OLMSTED MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 4TH ST SE
ROCHESTER MN
55904-4717
US

IV. Provider business mailing address

1650 4TH ST SE
ROCHESTER MN
55904-4717
US

V. Phone/Fax

Practice location:
  • Phone: 507-529-6610
  • Fax:
Mailing address:
  • Phone: 507-529-6610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: KEVIN HIGGINS
Title or Position: CFO
Credential:
Phone: 507-529-6610