Healthcare Provider Details

I. General information

NPI: 1790844413
Provider Name (Legal Business Name): MAYO CLINIC HEALTH SYSTEM-ST JAMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MOULTON AND PARSONS DR
SAINT JAMES MN
56081-5550
US

IV. Provider business mailing address

1101 MOULTON AND PARSONS DR
SAINT JAMES MN
56081-5550
US

V. Phone/Fax

Practice location:
  • Phone: 507-375-3261
  • Fax: 507-375-8600
Mailing address:
  • Phone: 507-375-3261
  • Fax: 507-375-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number347104
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MORRIS MILLER
Title or Position: CFO
Credential:
Phone: 507-594-6449