| Organization Name: | MOOSE LAKE COMMUNITY HOSPITAL DISTRICT |
| NPI Number: | 1104902352 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON DOUGLAS (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 710 S Kenwood Ave Moose Lake |
| State: | MN US |
| Postal Code: | 557679405 |
| Phone Number: | 2184854481 |
| Fax Number: | 2184855845 |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 03/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 330829 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |