Provider Demographics
NPI:1649705690
Name:STEVENS COMMUNITY MEDICAL CENTER INC
Entity type:Organization
Organization Name:STEVENS COMMUNITY MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-589-1313
Mailing Address - Street 1:400 E. 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:MN
Mailing Address - Zip Code:56267
Mailing Address - Country:US
Mailing Address - Phone:320-589-1313
Mailing Address - Fax:320-589-1065
Practice Address - Street 1:400 E. 1ST STREET
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:MN
Practice Address - Zip Code:56267
Practice Address - Country:US
Practice Address - Phone:320-589-1313
Practice Address - Fax:320-589-1065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEVENS COMMUNITY MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-04-27
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit