=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225106537
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARKVIEW HEALTHCARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2006
-----------------------------------------------------
Last Update Date | 12/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 MINNESOTA ST
-----------------------------------------------------
City | OSTRANDER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55961-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-657-2231
-----------------------------------------------------
Fax | 507-657-2403
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 305 MINNESOTA ST
-----------------------------------------------------
City | OSTRANDER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55961-4400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-657-2231
-----------------------------------------------------
Fax | 507-657-2403
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. GRANT D THAYER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 507-657-2231
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------