| Organization Name: | PINE MEDICAL CENTER |
| NPI Number: | 1659459931 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM ZWICKEY (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 109 Court Ave S Sandstone |
| State: | MN US |
| Postal Code: | 550725120 |
| Phone Number: | 3202455604 |
| Fax Number: | |
| NPI Enumeration Date: | 11/02/2006 |
| NPI Last Update Date: | 01/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0002X |
| License Number: | 330737 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Emergency Care |
| Taxonomy Definition: | |