Centracare - River Campus Clinic

LBN: Centracare Clinic
Centracare - River Campus Clinic is an health care organization with primary practice located at 1200 Sixth Ave No Centracare Clinic, St Cloud MN 56303-2735. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Multi-Specialty, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty. Centracare Clinic can be contacted via phone (320) 252-5131, or through Blair, Michael A via phone (320) 255-5665.

Contact Information

Primary practice address
1200 Sixth Ave No Centracare Clinic St Cloud MN 56303-2735
Phone: (320) 252-5131
Fax: (320) 240-2118
Website:
Map and Directions
Authorized official contact:
Name: Blair, Michael A
Phone: (320) 255-5665

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X Minnesota
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X Minnesota
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1043212665
LBN Legal business name Centracare Clinic
DBA Doing business as Centracare - River Campus Clinic
Authorized official Blair, Michael A
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 12th, 2005
Last updated Jul 21st, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043212665 NPPES
Other 6D053CE BLUE CROSS BLUE SHIELD
Other N002912 BLUE CROSS BLUE SHIELD
Other 98-04122 BLUE CROSS BLUE SHIELD
Other 35580 BLUE CROSS BLUE SHIELD
MEDICAID 990228700 BLUE CROSS BLUE SHIELD
Other 110890 BLUE CROSS BLUE SHIELD

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