| Organization Name: | CENTRACARE HEALTH-PAYNESVILLE LLC |
| NPI Number: | 1629402516 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY R KLUGHERZ (VICE PRESIDENT AND CFO) |
| Mailing Address: | 200 W 1st St Paynesville |
| State: | MN US |
| Postal Code: | 563621445 |
| Phone Number: | 3202433767 |
| Fax Number: | 3202433174 |
| NPI Enumeration Date: | 08/27/2013 |
| NPI Last Update Date: | 08/26/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC0050X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Critical Access Hospital |
| Taxonomy Definition: | An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |