| Centracare - St Cloud Medical Group South | |
|
1301 33rd St S Saint Cloud MN 56301-9668 | |
| (320) 251-8181 | |
| (320) 257-1733 |
| Full Name | Centracare - St Cloud Medical Group South |
|---|---|
| Speciality | Clinic/Center |
| Location | 1301 33rd St S, Saint Cloud, Minnesota |
| Authorized Official Name and Position | Michael A Blair (SR VP & CFO) |
| Authorized Official Contact | 3202555665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centracare - St Cloud Medical Group South 1200 6th Ave N Saint Cloud MN 56303-2735 Ph: (320) 252-5131 | Centracare - St Cloud Medical Group South 1301 33rd St S Saint Cloud MN 56301-9668 Ph: (320) 251-8181 |
| NPI Number | 1669994315 |
|---|---|
| Provider Enumeration Date | 07/14/2017 |
| Last Update Date | 11/19/2020 |
| Medicare PECOS PAC ID | 2466363395 |
|---|---|
| Medicare Enrollment ID | O20171017001116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669994315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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