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General NPI Number Information
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NPI Number | 1548212699
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Entity Type | Organization
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Legal Business Name | MILLE LACS HEALTH SYSTEM
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 200 ELM ST N
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City | ONAMIA
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State | MN
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Zip | 56359-7901
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Country | US
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Telephone | 320-532-3154
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Fax | 320-532-3111
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Provider Business Mailing Address
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Address Line | 200 ELM ST N PO BOX A
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City | ONAMIA
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State | MN
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Zip | 56359-7901
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Country | US
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Telephone | 320-532-3154
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Fax | 320-532-3111
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Authorized Official
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Title or Position | CFO
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Name | MR. JOHN W UNZEN
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Credential |
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Telephone | 320-532-2581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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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 | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 201047-0
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 343531
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 331503
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License Number State | MN
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