MEDCENTRA LLC; NPI #1851388920

Contact Information

MEDCENTRA LLC

225 SMITH AVE N
SUITE 301
SAINT PAUL, MN 55102-2534

Phone: 651-288-5180
Fax: 651-288-5188
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility

Indicates primary specialty

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NPI Profile & details for MEDCENTRA LLC

NPI Number	`1851388920`
LBN Legal business name	MEDCENTRA LLC
Authorized official	BRIAN SISKA - (PRESIDENT/)
Entity	Organization
Organization subpart ¹	No
Enumeration date	10/04/2005
Last updated	08/22/2020 - 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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