National Provider Identifier Database

GLENCOE REGIONAL HEALTH SERVICES
Critical Access


Contact Information

GLENCOE REGIONAL HEALTH SERVICES
1805 HENNEPIN AVE N
GLENCOE, MN55336-1416
Phone: 320-864-7716
Fax: 320-864-7186
Website:
Specialty Taxonomy Code
* Critical Access 282NC0060X
Institutional Pharmacy 3336I0012X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for GLENCOE REGIONAL HEALTH SERVICES

NPI Number 1508885633
Legal business name
LBN
GLENCOE REGIONAL HEALTH SERVICES
Authorized official JULIE LESKE - (CREDENTIALING COORDINATOR)
Entity Organization
Organization subpart No
Enumeration date 07/19/2006
Last updated 02/25/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 201001
  • MN Medicaid: 909545400
  • Other: 2144023 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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