Provider Demographics
NPI:1598458911
Name:MADELIA HEALTH
Entity Type:Organization
Organization Name:MADELIA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAVEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-642-3255
Mailing Address - Street 1:121 DREW AVE SE
Mailing Address - Street 2:
Mailing Address - City:MADELIA
Mailing Address - State:MN
Mailing Address - Zip Code:56062-1841
Mailing Address - Country:US
Mailing Address - Phone:076-423-2555
Mailing Address - Fax:
Practice Address - Street 1:401 N 4TH AVE E
Practice Address - Street 2:
Practice Address - City:TRUMAN
Practice Address - State:MN
Practice Address - Zip Code:56088-1108
Practice Address - Country:US
Practice Address - Phone:507-776-8783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health