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General NPI Number Information
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NPI Number | 1447108253
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Entity Type | Organization
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Legal Business Name | SUPERONE RHC
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 22418 STATE HIGHWAY 6 STE 300
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City | CROSBY
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State | MN
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Zip | 56441-2801
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Country | US
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Telephone | 218-546-7000
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Fax | 218-546-7268
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Provider Business Mailing Address
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Address Line | 320 E MAIN ST
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City | CROSBY
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State | MN
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Zip | 56441-1645
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Country | US
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Telephone | 218-546-7000
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Fax | 218-546-7268
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Authorized Official
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Title or Position | CONTRACTS AND REIMBURSEMENT ANALYST
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Name | DEANNA LYNN CARMICHAEL
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Credential |
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Telephone | 218-546-4386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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