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General NPI Number Information
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NPI Number | 1952521262
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Entity Type | Organization
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Legal Business Name | SEMCAC
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 204 ELM ST S
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City | RUSHFORD
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State | MN
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Zip | 55971-0549
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Country | US
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Telephone | 507-864-7741
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Fax | 507-864-2440
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Provider Business Mailing Address
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Address Line | 204 ELM ST S PO BOX 549
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City | RUSHFORD
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State | MN
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Zip | 55971-0549
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Country | US
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Telephone | 507-864-7741
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Fax | 507-864-2440
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. TERRY ERICKSON
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Credential |
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Telephone | 507-864-7741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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