MEDICARE: CAMBRIDGE NURSING HOME INC

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
1	314000000X	Skilled Nursing Facility		MN

General Provider Information

NPI Number	:	1255339578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMBRIDGE NURSING HOME INC

Provider Business Mailing Address
First Line	:	548 1ST AVE W
Second Line	:
City	:	CAMBRIDGE
State	:	MN
Zip	:	55008-1020
Country	:	US
Telephone Number	:	763-689-2323
Fax Number	:	763-689-2930

Provider Business Practice Location Address
First Line	:	548 1ST AVE W
Second Line	:
City	:	CAMBRIDGE
State	:	MN
Zip	:	55008-1020
Country	:	US
Telephone Number	:	763-689-2323
Fax Number	:	763-689-2930

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ROBERT SUNDBERG
Credential	:
Telephone Number	:	763-689-2323

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	08/22/2020

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