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NPI Code Detail

MEDICARE: MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION

MEDICARE: MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1073040838
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION
Provider Business Mailing Address
First Line : 2200 NW 26TH ST
Second Line :
City : OWATONNA
State : MN
Zip : 55060-5503
Country : US
Telephone Number : 507-333-3300
Fax Number :
Provider Business Practice Location Address
First Line : 300 STATE AVE
Second Line :
City : FARIBAULT
State : MN
Zip : 55021-6319
Country : US
Telephone Number : 507-333-3300
Fax Number :
Authorized Official
Title or Position : CHAIR ADMINISTRATION
Name : DOUGLAS PARKS
Credential :
Telephone Number : 507-266-5010
Provider Enumeration Date : 05/11/2017
Last Update Date : 06/16/2018

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Directions to “MAYO CLINIC HEALTH SYSTEM-SOUTHEAST MINNESOTA REGION ” Practice Location

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