Provider Demographics
NPI:1487678942
Name:STEVENS COMMUNITY MEDICAL CENTER INC
Entity Type:Organization
Organization Name:STEVENS COMMUNITY MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCEVILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-589-1313
Mailing Address - Street 1:400 E. 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267
Mailing Address - Country:US
Mailing Address - Phone:320-589-1313
Mailing Address - Fax:320-589-1065
Practice Address - Street 1:400 E. 1ST STREET
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267
Practice Address - Country:US
Practice Address - Phone:320-589-1313
Practice Address - Fax:320-589-1065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN241363Medicaid
MN241363Medicare Oscar/Certification
MNC06064Medicare Oscar/Certification