Centracare Kidney Program - Princeton Dialysis

LBN: St. Cloud Hospital
Centracare Kidney Program - Princeton Dialysis is an health care organization with primary practice located at 112 S Rum River Dr , Princeton MN 55371-1816. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. St. Cloud Hospital can be contacted via phone (763) 389-7969, or through Blair, Michael A. via phone (320) 255-5665.

Contact Information

Primary practice address
112 S Rum River Dr Princeton MN 55371-1816
Phone: (763) 389-7969
Fax: (320) 656-7009
Website:
Map and Directions
Authorized official contact:
Name: Blair, Michael A.
Phone: (320) 255-5665

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 331506 Minnesota
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1730138223
LBN Legal business name St. Cloud Hospital
DBA Doing business as Centracare Kidney Program - Princeton Dialysis
Authorized official Blair, Michael A.
Entity Organization
Organization subpart 1 No
Enumeration date May 10th, 2006
Last updated Oct 10th, 2019 - about 5 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 1730138223 NPPES
Minnesota MEDICAID 883747300

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