MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION (NPI# 1962675496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962675496 |
| Entity Type | Organization |
| Organization Name | MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION |
| Other Organization Name | MAYO CLINIC STORE MANKATO |
| Practice Address |
1400 Madison Ave Ste 100a Mankato MN 56001 |
| Mailing Address |
1025 Marsh St Mankato MN 56001-4752 |
| Practice Telephone | 5075942689 |
| Practice Fax Number | 5075946370 |
| Mailing Telephone | 5076254031 |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2018-07-16 |
| Authorized Official Name | TERRY BRANDT (CHAIR ADMINISTRATION) |
| Authorized Official Telephone | 5073856562 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 339098 | MN | Suppliers |
| Other Name | Type Code |
|---|---|
| Mayo Clinic Store Mankato | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124035282 | Mayo Clinic Health System-southwest Minnesota Region | General Acute Care Hospital | 301 2nd Street Ne, New Prague, MN 56071 | 2006-08-02 |
| 1619945052 | Mayo Clinic Health System-southwest Minnesota Region | General Acute Care Hospital | 625 N Jackson Ave, Springfield, MN 56087-1714 | 2006-03-10 |
| 1740256668 | Mayo Clinic Health System-southwest Minnesota Region | General Acute Care Hospital | 501 North State Street, Waseca, MN 56093 | 2006-02-28 |
| 1851374169 | Mayo Clinic Health System-southwest Minnesota Region | Hospice Care, Community Based | 1400 E Madison Ave, Suite 324a, Mankato, MN 56001-5473 | 2005-11-22 |
| 1518494251 | Mayo Clinic Health System-southwest Minnesota Region | Clinic/Center | 501 State St N, Waseca, MN 56093-2811 | 2017-05-12 |
| 1477089407 | Mayo Clinic Health System-southwest Minnesota Region | Clinic/Center | 301 2nd St Ne, New Prague, MN 56071-1709 | 2017-05-11 |
| 1972030740 | Mayo Clinic Health System-southwest Minnesota Region | Clinic/Center | 625 N Jackson Ave, Springfield, MN 56087-1714 | 2017-05-11 |
| 1790212561 | Mayo Clinic Health System-southwest Minnesota Region | Clinic/Center | 800 Medical Center Dr, Fairmont, MN 56031-4575 | 2017-05-11 |
| 1881121648 | Mayo Clinic Health System-southwest Minnesota Region | Durable Medical Equipment & Medical Supplies | 800 Medical Center Dr, Fairmont, MN 56031-4575 | 2017-05-11 |
| 1225473770 | Mayo Clinic Health System-southwest Minnesota Region | Non-Pharmacy Dispensing Site | 625 N Jackson Ave, Springfield, MN 56087-1714 | 2013-05-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION | 1025 Marsh St, Mankato, MN 56001-4752 |
| Street Address |
1400 MADISON AVE STE 100A |
| City | MANKATO |
| State | MN |
| Zip Code | 56001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508412800 | Mayo Foundation for Medical Education & Research | Durable Medical Equipment & Medical Supplies | 1400 Madison Ave Ste 100a, Mankato, MN 56001-5260 | 2019-08-13 |
| 1962865600 | Leslie Grommersch | Physical Therapist | 1400 Madison Ave Ste 100a, Mankato, MN 56001-5260 | 2016-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922438167 | Handi Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 1400 Madison Ave Ste 336, Mankato, MN 56001-5465 | 2013-11-26 |
| 1417299793 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 1831 Madison Ave, Mankato, MN 56001-5449 | 2013-03-25 |
| 1851644827 | Allina Health System | Durable Medical Equipment & Medical Supplies | 1600 Madison Ave, Suite 110, Mankato, MN 56001-5470 | 2012-10-16 |
| 1700180692 | Grand St Paul Cvs L L C | Durable Medical Equipment & Medical Supplies | 1175 Madison Ave, Mankato, MN 56001-5227 | 2011-01-06 |
| 1346544681 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1610 Monks Ave, Mankato, MN 56001-5173 | 2010-12-30 |
| 1447452453 | Cn Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 1408 N Riverfront Dr, Mankato, MN 56001-3253 | 2007-06-01 |
| 1316081953 | Eyemart Express, Ltd. | Durable Medical Equipment & Medical Supplies | 1872 E Madison Ave, Mankato, MN 56001-5497 | 2007-02-16 |
| 1831259613 | Hope Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 404 Hope St, Mankato, MN 56001-5225 | 2006-12-11 |
| 1396851606 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1200 S Riverfront Dr, Mankato, MN 56001-2484 | 2006-08-21 |
| 1194830232 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1800 Madison Ave, Mankato, MN 56001 | 2006-08-20 |
| Find all providers in MANKATO | ||||
Please comment or provide details below to improve the information on MAYO CLINIC HEALTH SYSTEM-SOUTHWEST MINNESOTA REGION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.