| NPI | 1669994315 |
|---|---|
| Doing Business As | CENTRACARE - ST CLOUD MEDICAL GROUP SOUTH |
| Entity Type | Organization |
| Authorized Contact | MICHAEL A BLAIR Sr VP & CFO 320-255-5665 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2020-11-19 |