Provider Demographics
NPI:1124014881
Name:PIPESTONE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:PIPESTONE COUNTY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BURRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-825-5811
Mailing Address - Street 1:916 4TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:PIPESTONE
Mailing Address - State:MN
Mailing Address - Zip Code:56164-1890
Mailing Address - Country:US
Mailing Address - Phone:507-825-5811
Mailing Address - Fax:507-825-5733
Practice Address - Street 1:916 4TH AVE SW
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-1890
Practice Address - Country:US
Practice Address - Phone:507-825-5811
Practice Address - Fax:507-825-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327538282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN430081OtherDAKOTA HEALH PLAN
MN236064MOtherFEDERATED MUTUAL
MN21041OtherHEALTH PARTNERS
MN824121632OtherPRIMEWEST
MN1017039OtherPREFERRED ON
MN1811EPIOtherBLUE CROSS
MN5025427OtherMEDICA
MN8017039OtherPERFEREED ONE ADM SERV
MN824121632OtherPRIMEWEST