Provider Demographics
NPI:1932387255
Name:HEALTHPARTNERS RC
Entity Type:Organization
Organization Name:HEALTHPARTNERS RC
Other - Org Name:RENVILLE COUNTY HOSPITAL AND CLINICS - OLIVIA CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-523-3575
Mailing Address - Street 1:100 HEALTHY WAY
Mailing Address - Street 2:
Mailing Address - City:OLIVIA
Mailing Address - State:MN
Mailing Address - Zip Code:56277-1117
Mailing Address - Country:US
Mailing Address - Phone:320-523-1261
Mailing Address - Fax:320-523-3458
Practice Address - Street 1:100 HEALTHY WAY
Practice Address - Street 2:
Practice Address - City:OLIVIA
Practice Address - State:MN
Practice Address - Zip Code:56277-1117
Practice Address - Country:US
Practice Address - Phone:320-523-1460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHPARTNERS RC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-08
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN24-3442OtherMEDICARE CCN / CERTIFICAT