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General NPI Number Information
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NPI Number | 1447235031
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Entity Type | Organization
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Legal Business Name | ST CLOUD AREA SURGERY CTR
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2000 ABBOTT NORTHWESTERN CT SUITE 305
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City | SARTELL
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State | MN
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Zip | 56377-4202
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Country | US
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Telephone | 320-534-2200
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Fax | 320-534-2204
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Provider Business Mailing Address
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Address Line | 2000 ABBOTT NORTHWESTERN CT SUITE 305
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City | SARTELL
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State | MN
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Zip | 56377-4202
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Country | US
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Telephone | 320-534-2200
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Fax | 320-534-2204
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Authorized Official
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Title or Position | INTERIM EXECUTIVE DIRECTOR
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Name | DEBRA A RUDQUIST
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Credential | RN MS
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Telephone | 612-863-4716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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