Basic Information
| Provider Information | |||||||||
| NPI: | 1902960875 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AITKIN COMMUNITY HOSPITAL, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RIVERWOOD HEALTHCARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 BUNKER HILL DR | ||||||||
| Address2: | |||||||||
| City: | AITKIN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 564311865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2189272157 | ||||||||
| FaxNumber: | 2189274130 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 BUNKER HILL DR | ||||||||
| Address2: | |||||||||
| City: | AITKIN | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2189272157 | ||||||||
| FaxNumber: | 2189274130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2006 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | WESTMAN | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2189275501 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
ID Information
| ID | Type | State | Issuer | Description | 848136900 | 05 | MN | MEDICAID | 47305 | 01 | HEALTH PARTNERS | OTHER | 39A31RI | 01 | BLUE CROSS | OTHER | 105805 | 01 | MN | UCARE | OTHER |