Provider Demographics
NPI:1689669871
Name:NORTHFIELD HOSPITAL
Entity Type:Organization
Organization Name:NORTHFIELD HOSPITAL
Other - Org Name:NORTHFIELD HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:EDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-646-1416
Mailing Address - Street 1:2000 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057
Mailing Address - Country:US
Mailing Address - Phone:507-646-1457
Mailing Address - Fax:507-646-1395
Practice Address - Street 1:1604 RIVERVIEW LN
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057
Practice Address - Country:US
Practice Address - Phone:507-646-1457
Practice Address - Fax:507-646-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327061251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN722-3471-00Medicaid
MN722-3471-00Medicaid