| NPI | 1013104348 |
|---|---|
| Doing Business As | CENTRACARE - BIG LAKE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL A BLAIR Sr VP & CFO 320-255-5665 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2020-11-19 |