OrganizationActive
Centracare Clinic - Long Prairie
NPI 1184890097 · Non-Pharmacy Dispensing Site · Long Prairie, MN
Provider details
- NPI number
- 1184890097
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp of Operations(858) 625-2990
- License
- 36275 (MN)
Specialties & taxonomies
Suppliers
Practice location
24 9th St Se
Long Prairie, MN 56347-1404
Phone: (320) 732-2131
Approximate (ZIP-level) locationGet directions
Mailing address
9276 Scranton Rd
San Diego, CA 92121-7701
Registry dates
- Enumerated
- 2008-05-01
- Last updated
- 2015-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.