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NPI Code Detail

MEDICARE: MAYO CLINIC HEALTH SYSTEM-LAKE CITY

MEDICARE: MAYO CLINIC HEALTH SYSTEM-LAKE CITY
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
1282NC0060XCritical Access HospitalMN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
201008475OTHERMNPREFERRED ONE
35000137OTHERMNMEDICA
455304OTHERMNHEALTH PARTNERS
532B87LAOTHERMNBCBS
67B99HLAOTHERMNBCBS UB92
7300802OTHERMNUCARE

General Provider Information

NPI Number : 1538113022
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAYO CLINIC HEALTH SYSTEM-LAKE CITY
Provider Business Mailing Address
First Line : 500 W GRANT ST
Second Line :
City : LAKE CITY
State : MN
Zip : 55041-1143
Country : US
Telephone Number : 651-345-3321
Fax Number : 651-345-1151
Provider Business Practice Location Address
First Line : 500 W GRANT ST
Second Line :
City : LAKE CITY
State : MN
Zip : 55041-1143
Country : US
Telephone Number : 651-345-3321
Fax Number : 651-345-1151
Authorized Official
Title or Position : CFO
Name : PRAVEEN MEKALA
Credential :
Telephone Number : 507-594-6449
Provider Enumeration Date : 05/20/2006
Last Update Date : 08/18/2025

Similar Medicare Providers

1689650350 — ANN MARIE LOWE M.D.
Practice Location Address:
500 W GRANT ST
LAKE CITY, MN
55041-1143
Practice Phone: 651-345-3321
Practice Fax: 651-345-1151
1033195656 — DENNIS CHARLES SPANO M.D.
Practice Location Address:
500 W GRANT ST
LAKE CITY, MN
55041-1143
Practice Phone: 651-345-3321
Practice Fax: 651-345-1151
1134105703 — KATHERINE LILLIE LOFBERG FNP-C
Practice Location Address:
500 W GRANT ST
LAKE CITY, MN
55041-1143
Practice Phone: 651-345-3321
Practice Fax: 651-345-1151
1437139714 — ROBERT A TAYLOR DO
Practice Location Address:
500 W GRANT ST
LAKE CITY, MN
55041-1143
Practice Phone: 651-364-5600
Practice Fax:
1275508111 — MARK DAVID SWENSON CRNA
Practice Location Address:
500 W GRANT ST
LAKE CITY, MN
55041-1143
Practice Phone: 651-345-3321
Practice Fax:
1487620738 — MAYO CLINIC HOSPITAL-ROCHESTER
Practice Location Address:
500 W GRANT ST
LAKE CITY, MN
55041-1143
Practice Phone: 651-345-3321
Practice Fax: 651-565-4818

Directions to “MAYO CLINIC HEALTH SYSTEM-LAKE CITY ” Practice Location

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