Centracare Clinic - Northway Family Medicine
LBN: Centracare Clinic
Centracare Clinic - Northway Family Medicine is an health care organization with primary practice located at 1555 Northway Drive , St Cloud MN 56303. 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) 251-1775, or through Blair, Michael A via phone (320) 255-5665.
Contact Information
Primary practice address
1555 Northway Drive
St Cloud MN 56303
Phone: (320) 251-1775
Fax: (320) 240-3131
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1881696490 |
|---|---|
| LBN Legal business name | Centracare Clinic |
| DBA Doing business as | Centracare Clinic - Northway Family Medicine |
| Authorized official | Blair, Michael A |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Nov 19th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881696490 | NPPES |
| Other | NA131 | PREF ONE | |
| Other | 86D71CE | PREF ONE | |
| Other | 35580 | PREF ONE | |
| Other | 98-01806 | PREF ONE | |
| Other | 110963 | PREF ONE | |
| MEDICAID | 990228700 | PREF ONE |
Popular Providers
-
Aeris Medical Group Pllc
2820 Inglewood Ave S , St Louis Park MN 55416-4112 -
Grand Valley Surgical Center, Llc
2680 Leonard St Ne Ste 1, Grand Rapids MI 49525-6902 -
Gillette Children'S Specialty Healthcare
200 East University Ave , St. Paul MN 55101 -
Centracare Clinic
2025 Stearns Way Ste 114 , Saint Cloud MN 56303 -
Centracare Clinic
1200 Sixth Ave No Centracare Clinic, St Cloud MN 56303-2735 -
Childrens Health Care
345 North Smith Avenue Childrens Specialty Clinics Stpl, St Paul MN 55102 -
Wilkes Barre Asc., Lp
545 N River St , Wilkes Barre PA 18702-2600 -
Centracare Clinic
1900 Centracare Cir Centracare Clinic Health Plaza, Saint Cloud MN 56303-5000