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General NPI Number Information
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NPI Number | 1831256320
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Entity Type | Organization
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Legal Business Name | CENTRACARE HEALTH SYSTEM-NR LLC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 1013 HART BLVD
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City | MONTICELLO
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State | MN
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Zip | 55362-8575
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Country | US
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Telephone | 763-271-2251
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Fax | 763-271-2346
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Provider Business Mailing Address
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Address Line | 1013 HART BLVD
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City | MONTICELLO
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State | MN
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Zip | 55362-8575
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Country | US
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Telephone | 763-271-2251
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Fax | 763-271-2346
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Authorized Official
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Title or Position | PHARMACY TECHNICIAN
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Name | REBECCA LECHNER
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Credential |
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Telephone | 763-271-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 264079
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License Number State | MN
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