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General NPI Number Information
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NPI Number | 1528026648
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Entity Type | Organization
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Legal Business Name | PAYNESVILLE AREA HOSPITAL DISTRICT
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 410 LUELLA ST
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City | WATKINS
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State | MN
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Zip | 55389-1012
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Country | US
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Telephone | 320-764-2300
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Fax | 320-764-2665
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Provider Business Mailing Address
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Address Line | 410 LUELLA ST
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City | WATKINS
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State | MN
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Zip | 55389-1012
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Country | US
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Telephone | 320-764-2300
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Fax | 320-764-2665
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Authorized Official
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Title or Position | CEO
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Name | BOBBE TEIGEN
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Credential |
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Telephone | 320-243-3767
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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 | 332123
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License Number State | MN
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