ST. CLOUD HOSPITAL (NPI# 1730138223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730138223 |
| Entity Type | Organization |
| Organization Name | ST. CLOUD HOSPITAL |
| Other Organization Name | CENTRACARE KIDNEY PROGRAM - PRINCETON DIALYSIS |
| Practice Address |
112 S Rum River Dr Princeton MN 55371-1816 |
| Mailing Address |
1406 6th Ave North Saint Cloud MN 56303-1900 |
| Practice Telephone | 7633897969 |
| Practice Fax Number | 3206567009 |
| Mailing Telephone | 3202512700 |
| Mailing Fax Number | 3206567009 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | MR. MICHAEL A. BLAIR (SR. VICE PRESIDENT AND CFO) |
| Authorized Official Telephone | 3202555665 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
331506 | MN | Ambulatory Health Care Facilities |
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 883747300 | 05 |
| Other Name | Type Code |
|---|---|
| CentraCare Kidney Program - Princeton Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841616877 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1495 10th Ave Ne, Sauk Rapids, MN 56379 | 2014-03-14 |
| 1912338666 | St. Cloud Hospital | Rehabilitation, Substance Use Disorder Unit | 1428 2nd St N, Sauk Rapids, MN 56379-2533 | 2013-12-06 |
| 1780020925 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1572 Co Rd 134, St. Cloud, MN 56303-0346 | 2013-05-15 |
| 1811150618 | St. Cloud Hospital | Rehabilitation, Substance Use Disorder Unit | 1564 Cty Rd 134, St Cloud, MN 56303-0346 | 2008-07-02 |
| 1427218957 | St. Cloud Hospital | Substance Abuse Rehabilitation Facility | 1485 10th Ave Ne, Sauk Rapids, MN 56379-9838 | 2008-06-09 |
| 1033391099 | St. Cloud Hospital | Clinic/Center | 520 Hwy 12 East, Suite 6, Litchfield, MN 55355 | 2007-12-03 |
| 1316063233 | St. Cloud Hospital | Clinic/Center | 520 11th Ave Sw, South Building, Cambridge, MN 55008-2003 | 2007-03-22 |
| 1912956400 | St. Cloud Hospital | Clinic/Center | 2024 So 6th St, Brainerd, MN 56401 | 2006-05-10 |
| 1821047317 | St. Cloud Hospital | Clinic/Center | 2035 15th St N, Suite 220, Saint Cloud, MN 56303-1738 | 2006-05-10 |
| 1760431266 | St. Cloud Hospital | Clinic/Center | 111 17th Ave East, Alexandria, MN 56308 | 2006-05-10 |
| Street Address |
112 S RUM RIVER DR |
| City | PRINCETON |
| State | MN |
| Zip Code | 55371-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053962530 | Monica Gail Broten | Technician | 30840 Tiger Street Nw, Princeton, MN 55371 | 2019-09-25 |
| 1215349584 | Stephen Destefano | Pharmacist | 31419 131st Street, Princeton, MN 55371 | 2014-05-21 |
| 1164798948 | Andrew Sudbeck | Counselor | 101 18th Avenue North, Princeton, MN 55371 | 2012-03-27 |
| 1073804803 | Sterling Pointe Senior Living LLC | Assisted Living Facility | 1250 Northland Drive, Princeton, MN 55371 | 2011-04-27 |
| 1568752533 | Rum River Health Services, Inc. | Substance Abuse Rehabilitation Facility | 3079 90th Avenue, Princeton, MN 55371 | 2011-04-12 |
| 1780989038 | Dr. Kynan Westermeyer, Dds, Pllc | Clinic/Center | 404 1st St. N, Princeton, MN 55371 | 2011-01-18 |
| 1275788085 | Cody James Leff | Pharmacist | 1100 11th Avenue South, Princeton, MN 55371 | 2008-11-20 |
| 1164679213 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1101 N 5th St, Princeton, MN 55371 | 2008-08-20 |
| 1801059639 | Rum River Health Services, Inc | Substance Abuse Rehabilitation Facility | 1506 1st Street, Princeton, MN 55371 | 2008-07-02 |
| 1497940928 | James Michael Mandt | Pharmacist | 911 Northland Drive, Fairview Northland Medical Center, Princeton, MN 55371 | 2007-09-07 |
| Find all providers in zip 55371 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649458076 | Princeton Dialysis LLC | Clinic/Center | 2227 Sherman Dr, Princeton, IN 47670-1062 | 2008-02-07 |
| 1346352150 | Bio-medical Applications of West Virginia, Inc. | Clinic/Center | 160 Springhaven Dr, Princeton, WV 24740-2357 | 2006-08-31 |
| 1184644593 | Dialysis Clinic Inc. | Clinic/Center | 88 Princeton Hightstown R, Princeton, NJ 08550 | 2006-07-20 |
| 1154300564 | Nra Princeton Kentucky LLC | Clinic/Center | 401 S Jefferson St, Princeton, KY 42445-2113 | 2006-01-13 |
| 1003139114 | Renal Treatment Centers-illinois Inc | Clinic/Center | 2227 Sherman Dr, Princeton, IN 47670-1062 | 2010-03-03 |
| 1720182595 | Bio-medical Applications of New Jersey, Inc. | Clinic/Center | 707 Alexander Rd, Bldg. 3, Ste. 301, Princeton, NJ 08540-6331 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183832 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 6160 Summit Dr N Ste 150, Brooklyn Center, MN 55430-2118 | 2020-10-28 |
| 1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
| 1225541055 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 7433 Currell Blvd, Woodbury, MN 55125-2217 | 2017-11-15 |
| 1154856839 | Avera Marshall | Clinic/Center | 300 S Bruce St Ste D, Marshall, MN 56258-1934 | 2017-05-01 |
| 1225573777 | Atlantic Dialysis LLC | Clinic/Center | 1802 Commerce Dr, North Mankato, MN 56003-1800 | 2016-12-19 |
| 1437694981 | Atlantic Dialysis LLC | Clinic/Center | 701 N Broadway St, New Ulm, MN 56073-1201 | 2016-12-19 |
| 1467801860 | Total Renal Care, Inc. | Clinic/Center | 20184 Heritage Dr, Lakeville, MN 55044-6855 | 2016-06-07 |
| 1003292392 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 17592 Dodd Blvd, Lakeville, MN 55044-3909 | 2015-08-10 |
| 1629461470 | Babler Dialysis, LLC | Clinic/Center | 2660 S Broadway, Ste A, Rochester, MN 55904-6263 | 2015-03-17 |
| 1588067391 | Meesa Dialysis LLC | Clinic/Center | 245 Isle St W, Isle, MN 56342-4908 | 2014-10-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.