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General NPI Number Information
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NPI Number | 1013206812
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Entity Type | Organization
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Legal Business Name | HENDRICKS COMMUNITY HOSPITAL ASSN & RETIREMENT HOME
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 501 E LINCOLN ST
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City | HENDRICKS
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State | MN
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Zip | 56136-9598
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Country | US
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Telephone | 507-275-3121
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Fax | 507-275-3194
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Provider Business Mailing Address
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Address Line | 501 E LINCOLN ST PO BOX 106
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City | HENDRICKS
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State | MN
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Zip | 56136-9598
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Country | US
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Telephone | 507-275-3134
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Fax | 507-275-2242
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Authorized Official
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Title or Position | CEO
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Name | MR. JEFF GOLLAHER
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Credential |
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Telephone | 507-275-3134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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