Provider Demographics
NPI:1659314789
Name:DEER RIVER HEALTHCARE CENTER, INC.
Entity Type:Organization
Organization Name:DEER RIVER HEALTHCARE CENTER, INC.
Other - Org Name:ESSENTIA HEALTH REMER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FELTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-742-8662
Mailing Address - Street 1:9 BIRCH ST NE
Mailing Address - Street 2:
Mailing Address - City:REMER
Mailing Address - State:MN
Mailing Address - Zip Code:56672-4469
Mailing Address - Country:US
Mailing Address - Phone:218-566-1441
Mailing Address - Fax:
Practice Address - Street 1:9 BIRCH ST NE
Practice Address - Street 2:
Practice Address - City:REMER
Practice Address - State:MN
Practice Address - Zip Code:56672-4469
Practice Address - Country:US
Practice Address - Phone:218-566-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST MARY'S DULUTH CLINIC HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-14
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1659314789Medicaid
MNC06489Medicare PIN
MN1659314789Medicaid
MNC06025Medicare PIN