MEDICARE: STERLING PARK HEALTHCARE CENTER 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	327790	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7122702	OTHER	MN	MEDICA
2	9F08ST	OTHER	MN	BLUE CROSS BLUE SHIELD
3	NH0479	OTHER	MN	UCARE
4	73694	OTHER	MN	HEALTHPARTNERS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861480345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STERLING PARK HEALTHCARE CENTER INC

Provider Business Mailing Address
First Line	:	142 1ST ST N
Second Line	:
City	:	WAITE PARK
State	:	MN
Zip	:	56387-1273
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 1ST ST N
Second Line	:
City	:	WAITE PARK
State	:	MN
Zip	:	56387-1273
Country	:	US
Telephone Number	:	320-252-9595
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HOWIE GROFF
Credential	:
Telephone Number	:	952-888-2923

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	10/14/2008

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