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General NPI Number Information
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NPI Number | 1396117032
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Entity Type | Organization
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Legal Business Name | CENTRACARE HEALTH SYSTEM - MELROSE
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Dates
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Enumeration Date | 10/21/2015
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 320 3RD AVE
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City | ALBANY
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State | MN
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Zip | 56307-9363
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Country | US
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Telephone | 320-251-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 6TH AVE N
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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 |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/HOSPITAL PRESIDENT
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Name | CRAIG BROMAN
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Credential |
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Telephone | 320-251-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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