Provider Demographics
NPI:1225106537
Name:PARKVIEW HEALTHCARE INC
Entity Type:Organization
Organization Name:PARKVIEW HEALTHCARE INC
Other - Org Name:OSTRANDER NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:THAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-657-2231
Mailing Address - Street 1:305 MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:OSTRANDER
Mailing Address - State:MN
Mailing Address - Zip Code:55961-4400
Mailing Address - Country:US
Mailing Address - Phone:507-657-2231
Mailing Address - Fax:507-657-2403
Practice Address - Street 1:305 MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:OSTRANDER
Practice Address - State:MN
Practice Address - Zip Code:55961-4400
Practice Address - Country:US
Practice Address - Phone:507-657-2231
Practice Address - Fax:507-657-2403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN4660OSOtherBLUE CROSS BLUE SHIELD
MNUCAREOtherUCARE
MN4660OSOtherBLUE CROSS BLUE SHIELD