| Cos Pllc | |
|
384 3rd St Ne Waite Park MN 56387-1874 | |
| (320) 250-9188 | |
| (320) 396-7300 |
| Full Name | Cos Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 384 3rd St Ne, Waite Park, Minnesota |
| Authorized Official Name and Position | Paul Colligan (CO-OWNER) |
| Authorized Official Contact | 6027900617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cos Pllc 384 3rd St Ne Waite Park MN 56387-1874 Ph: (320) 250-9188 | Cos Pllc 384 3rd St Ne Waite Park MN 56387-1874 Ph: (320) 250-9188 |
| NPI Number | 1083317812 |
|---|---|
| Provider Enumeration Date | 03/22/2023 |
| Last Update Date | 03/22/2023 |
| Certification Date | 03/22/2023 |
| Medicare PECOS PAC ID | 9234594425 |
|---|---|
| Medicare Enrollment ID | O20230421001323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083317812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michael R Singh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043493182 PECOS PAC ID: 3577647155 Enrollment ID: I20080220000505 |
| Provider Name | Paul A Colligan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417321829 PECOS PAC ID: 7315249406 Enrollment ID: I20160106001954 |
| Provider Name | Amy J Lavalla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215312236 PECOS PAC ID: 8224344890 Enrollment ID: I20160510001346 |
| Provider Name | Juli Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922754134 PECOS PAC ID: 1759740368 Enrollment ID: I20230629002590 |
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