Healthcare Provider Details

I. General information

NPI: 1114837960
Provider Name (Legal Business Name): RIDGEVIEW MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 4TH ST N
WINSTED MN
55395-7788
US

IV. Provider business mailing address

551 4TH ST N
WINSTED MN
55395-7788
US

V. Phone/Fax

Practice location:
  • Phone: 952-442-3190
  • Fax:
Mailing address:
  • Phone: 952-442-3190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BRENT WORDELMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 952-442-2191