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General NPI Number Information
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NPI Number | 1043269798
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Entity Type | Organization
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Legal Business Name | ST. CLOUD HOSPITAL
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 1406 6TH AVE NORTH
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1900
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Country | US
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Telephone | 320-307-3676
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Fax | 320-656-7009
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Provider Business Mailing Address
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Address Line | 1406 6TH AVE NORTH
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1900
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Country | US
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Telephone | 320-307-3676
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Fax | 320-656-7009
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Authorized Official
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Title or Position | SR. VICE PRESIDENT & CFO
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Name | MR. MICHAEL A. BLAIR
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Credential |
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Telephone | 320-307-3676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 331506
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License Number State | MN
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