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General NPI Number Information
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NPI Number | 1417105552
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Entity Type | Organization
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Legal Business Name | STEVENS COMMUNITY MEDICAL CENTER INC.
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 501 POLER ST
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City | STARBUCK
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State | MN
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Zip | 56381-2456
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Country | US
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Telephone | 320-239-3939
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Fax | 320-239-2802
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Provider Business Mailing Address
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Address Line | 400 E. 1ST STREET
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City | MORRIS
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State | MN
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Zip | 56267
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Country | US
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Telephone | 320-239-3939
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Fax | 320-239-2802
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. KERRIE MCEVILLY
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Credential |
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Telephone | 320-589-1313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | MN
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