Provider Demographics
NPI:1255470332
Name:CITY OF BLOOMING PRAIRIE
Entity type:Organization
Organization Name:CITY OF BLOOMING PRAIRIE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CITY CLERK
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ZWIENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-583-7573
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:BLOOMING PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55917
Mailing Address - Country:US
Mailing Address - Phone:507-583-7573
Mailing Address - Fax:507-583-4520
Practice Address - Street 1:501 4TH STREET SE
Practice Address - Street 2:
Practice Address - City:BLOOMING PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55917-1371
Practice Address - Country:US
Practice Address - Phone:507-583-7573
Practice Address - Fax:507-583-4520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN167883OtherUCARE MINNESOTA
MN35019BLOtherBLUE CROSS
MN493267600Medicaid
590014914OtherRAILROAD MEDICARE
MN167883OtherUCARE MINNESOTA