Healthcare Provider Details

I. General information

NPI: 1619179801
Provider Name (Legal Business Name): CITY OF ST. CHARLES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 WHITEWATER AVE
SAINT CHARLES MN
55972-1129
US

IV. Provider business mailing address

830 WHITEWATER AVE
SAINT CHARLES MN
55972-1129
US

V. Phone/Fax

Practice location:
  • Phone: 507-932-3020
  • Fax:
Mailing address:
  • Phone: 507-932-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0214
License Number StateMN

VIII. Authorized Official

Name: KRISTINE KAY HUINKER
Title or Position: ACCOUNTANT
Credential:
Phone: 507-932-3020