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NPI Code Detail

MEDICARE: ST MARYS REGIONAL HEALTH CENTER

MEDICARE: ST MARYS REGIONAL HEALTH CENTER
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
1333600000XPharmacy

General Provider Information

NPI Number : 1447240304
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST MARYS REGIONAL HEALTH CENTER
Provider Business Mailing Address
First Line : 1027 WASHINGTON AVE
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-3409
Country : US
Telephone Number : 218-847-5611
Fax Number : 218-847-0881
Provider Business Practice Location Address
First Line : 1027 WASHINGTON AVE
Second Line :
City : DETROIT LAKES
State : MN
Zip : 56501-3409
Country : US
Telephone Number : 218-847-5611
Fax Number : 218-847-0881
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : NATE MEYER
Credential :
Telephone Number : 218-847-5611
Provider Enumeration Date : 10/24/2005
Last Update Date : 08/22/2020

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Directions to “ST MARYS REGIONAL HEALTH CENTER ” Practice Location

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