CENTRACARE CLINIC; NPI #1255853115

Contact Information

CENTRACARE CLINIC

615 NELSON DRIVE
PO BOX 217
CLEARWATER, MN 55320

Phone: 320-558-2293
Fax: 320-685-4020
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for CENTRACARE CLINIC

NPI Number	`1255853115`
LBN Legal business name	CENTRACARE CLINIC
Authorized official	MICHAEL BLAIR - (SR VP & CFO)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	07/12/2017
Last updated	11/19/2020 - About 6 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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