Provider Demographics
NPI:1609135003
Name:BENEDICTINE CARE CENTERS
Entity Type:Organization
Organization Name:BENEDICTINE CARE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REIMBURSEMENT AND PAYMENT
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-991-6519
Mailing Address - Street 1:213 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-3921
Mailing Address - Country:US
Mailing Address - Phone:651-388-1234
Mailing Address - Fax:651-385-3420
Practice Address - Street 1:213 PIONEER RD
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066
Practice Address - Country:US
Practice Address - Phone:651-388-1234
Practice Address - Fax:651-385-3420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEDICTINE HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-07
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN245449Medicare Oscar/Certification