Provider Demographics
NPI:1952370348
Name:CITY OF SLEEPY EYE
Entity Type:Organization
Organization Name:CITY OF SLEEPY EYE
Other - Org Name:SLEEPY EYE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SELLHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-794-8440
Mailing Address - Street 1:400 4TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SLEEPY EYE
Mailing Address - State:MN
Mailing Address - Zip Code:56085-1109
Mailing Address - Country:US
Mailing Address - Phone:507-794-3571
Mailing Address - Fax:507-794-5950
Practice Address - Street 1:400 4TH AVE NW
Practice Address - Street 2:
Practice Address - City:SLEEPY EYE
Practice Address - State:MN
Practice Address - Zip Code:56085-1109
Practice Address - Country:US
Practice Address - Phone:507-794-3571
Practice Address - Fax:507-794-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327647275N00000X, 282N00000X, 282NC0060X
MN0915450001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282N00000XHospitalsGeneral Acute Care Hospital
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN400031OtherUCARE PROF FEE-H152
1014192OtherPREFERRED ONE
MN6340860OtherAETNA
5025400OtherMEDICA
MN60933SLOtherDME-BLUE CROSS BLUE SHIEL
300730OtherUCARE
MN315045300Medicaid
1856HSLOtherBLUE CROSS BLUE SHIELD
24Z327Medicare Oscar/Certification
5025400OtherMEDICA
MN6340860OtherAETNA