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Contact Information

CENTRACARE HEALTH - PAYNESVILLE LLC
200 W 1ST ST
PAYNESVILLE, MN56362
 Phone: 320-243-3767
 Fax: 320-243-7519
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CENTRACARE HEALTH - PAYNESVILLE LLC

NPI Number 1760440846
LBN Legal business name CENTRACARE HEALTH - PAYNESVILLE LLC
Authorized official MICHAEL BLAIR - (SR. VICE PRESIDENT AND CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/01/2006
Last updated 10/10/2019 - About 7 years ago
Identifiers
MN Medicaid 333747200
Other 1802HPA HOSP & SWING BED BCBS
Other 10141401 HOSP. HEALTH PARTNERS
Other 5003780 HOSP. MEDICA
Other 1006079 HOSP. PREF. ONE
Other 03072202705 HOSP. PRIMEWEST
Other 300173 HOSP. UCARE
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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