Healthcare Provider Details

I. General information

NPI: 1245280080
Provider Name (Legal Business Name): RICE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 WILLMAR AVE SW
WILLMAR MN
56201-2882
US

IV. Provider business mailing address

1801 WILLMAR AVE SW
WILLMAR MN
56201-2882
US

V. Phone/Fax

Practice location:
  • Phone: 320-214-2700
  • Fax: 320-214-2765
Mailing address:
  • Phone: 320-214-2700
  • Fax: 320-214-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number330432
License Number StateMN

VIII. Authorized Official

Name: MR. WILLIAM FENSKE
Title or Position: CFO
Credential:
Phone: 320-231-4009