NPIMap

Organization Active NPI

Glacial Ridge Health System

  • Non-Pharmacy Dispensing Site
  • Glenwood, MN
National Provider Identifier
1811240336
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
GLACIAL RIDGE HEALTH SYSTEM
Practice address
10 4TH Ave SE
Glenwood, MN 56334-1820
Phone
(320) 634-5157
NPI assigned
Oct 22, 2012
Last updated
Oct 22, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
GLACIAL RIDGE HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kirk Stensrud
Title
Ceo
Phone
(320) 634-4521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

10 4TH Ave SE
Glenwood, MN 56334-1820

Mailing address

6501 City West Pkwy
Eden Prairie, MN 55344-3248
Phone (952) 653-2525

Other names 1

  • Glacial Ridge Hospital - Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Glacial Ridge Hospital7 organizations share this tax ID, including this one
Part of
Glacial Ridge Hospital

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1811240336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CITY WEST PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443248",
            "telephone_number": "952-653-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 4TH AVE SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341820",
            "telephone_number": "320-634-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIAL RIDGE HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLACIAL RIDGE HEALTH SYSTEM",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "STENSRUD",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-634-4521"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glacial Ridge Hospital - Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glenwood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.