Provider Demographics
NPI:1619064193
Name:RICE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:RICE MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HINDERKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-231-4425
Mailing Address - Street 1:301 BECKER AVE SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3302
Mailing Address - Country:US
Mailing Address - Phone:320-231-4425
Mailing Address - Fax:320-231-4879
Practice Address - Street 1:301 BECKER AVE SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3302
Practice Address - Country:US
Practice Address - Phone:320-231-4425
Practice Address - Fax:320-231-4879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN331093282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1009424OtherPREFFERED ONE
ND12342Medicaid
MN5011459OtherMEDICA
MN298745700Medicaid
MN300126OtherUCARE
MN505462350OtherAETNA
MN1922HRIOtherBCBS HOSPITAL
MN1922HRISOtherBCBS IP OP
MN117120944OtherPRIME WEST
MN117120944OtherPRIME WEST
MN300126OtherUCARE
ND12342Medicaid
MN5011459OtherMEDICA