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General NPI Number Information
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NPI Number | 1396737417
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Entity Type | Organization
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Legal Business Name | EVELETH HOSPITAL, INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 227 MCKINLEY AVE
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City | EVELETH
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State | MN
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Zip | 55734-1606
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Country | US
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Telephone | 218-744-1950
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Fax | 218-744-3868
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Provider Business Mailing Address
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Address Line | 227 MCKINLEY AVE
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City | EVELETH
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State | MN
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Zip | 55734-1606
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Country | US
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Telephone | 218-744-1950
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Fax | 218-744-3868
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | JAMES Q FORSMAN
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Credential |
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Telephone | 218-744-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State | MN
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