Provider Demographics
NPI:1578736492
Name:HEALTHPARTNERS RC
Entity Type:Organization
Organization Name:HEALTHPARTNERS RC
Other - Org Name:HECTOR CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-523-3575
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:
Mailing Address - City:OLIVIA
Mailing Address - State:MN
Mailing Address - Zip Code:56277-1114
Mailing Address - Country:US
Mailing Address - Phone:320-523-1261
Mailing Address - Fax:320-523-8349
Practice Address - Street 1:131 BIRCH AVENUE
Practice Address - Street 2:
Practice Address - City:HECTOR
Practice Address - State:MN
Practice Address - Zip Code:55342-0117
Practice Address - Country:US
Practice Address - Phone:320-848-6294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHPARTNERS RC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-11
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN24-3443OtherMEDICARE CCN / CERTIFICAT