Provider Demographics
NPI:1942934112
Name:PRIMEWEST RURAL MINNESOTA HEALTH CARE ACCESS INITIATIVE
Entity Type:Organization
Organization Name:PRIMEWEST RURAL MINNESOTA HEALTH CARE ACCESS INITIATIVE
Other - Org Name:PRIMEWEST HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAFTHEFER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:320-335-5392
Mailing Address - Street 1:3905 DAKOTA ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-3391
Mailing Address - Country:US
Mailing Address - Phone:320-335-5239
Mailing Address - Fax:
Practice Address - Street 1:3905 DAKOTA ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-3391
Practice Address - Country:US
Practice Address - Phone:320-335-5239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization