| Organization Name: | ST CLOUD HOSPITAL |
| NPI Number: | 1801845391 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY R KLUGHERZ (VICE PRESIDENT AND CFO) |
| Mailing Address: | 16830 198th Ave Nw Big Lake Clinic Big Lake |
| State: | MN US |
| Postal Code: | 55309 |
| Phone Number: | 7632637320 |
| Fax Number: | 3206567009 |
| NPI Enumeration Date: | 05/10/2006 |
| NPI Last Update Date: | 08/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 331506 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |