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NPI Code Detail

MEDICARE: ST CROIX HOSPICE LLC

MEDICARE: ST CROIX HOSPICE LLC
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
1251G00000XCommunity Based Hospice Care Agency

General Provider Information

NPI Number : 1770142762
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST CROIX HOSPICE LLC
Provider Business Mailing Address
First Line : 7755 3RD ST N STE 200
Second Line :
City : OAKDALE
State : MN
Zip : 55128-5461
Country : US
Telephone Number : 651-735-3656
Fax Number : 651-735-0155
Provider Business Practice Location Address
First Line : 1001 S POKEGAMA AVE STE D
Second Line :
City : GRAND RAPIDS
State : MN
Zip : 55744-3919
Country : US
Telephone Number : 218-212-7915
Fax Number : 218-301-0725
Authorized Official
Title or Position : CEO
Name : HEATH A BARTNESS
Credential :
Telephone Number : 651-328-6914
Provider Enumeration Date : 06/12/2019
Last Update Date : 11/02/2022

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Directions to “ST CROIX HOSPICE LLC ” Practice Location

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