| Hennepin County Medical Center | |
|
701 Park Ave P1-finance Minneapolis MN 55415-1623 | |
| (612) 873-3000 | |
| (612) 904-4259 |
| Full Name | Hennepin County Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 701 Park Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Derrick Hollings (CFO) |
| Authorized Official Contact | 6128735340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hennepin County Medical Center 701 Park Ave P1-finance Minneapolis MN 55415-1623 Ph: (612) 873-3000 | Hennepin County Medical Center 701 Park Ave P1-finance Minneapolis MN 55415-1623 Ph: (612) 873-3000 |
| NPI Number | 1356369524 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 12/15/2022 |
| Certification Date | 12/15/2022 |
| Medicare PECOS PAC ID | 4789684861 |
|---|---|
| Medicare Enrollment ID | O20070115000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356369524 | NPI | - | NPPES |
| 41-6005801 | Other | MN | EMPLOYER IDENTIFICATION N |
| 157245800 | Medicaid | MN | |
| 06922HE | Other | MN | BLUE SHIELD |
| 1020HHE | Other | MN | BLUE CROSS |
| 157245802 | Medicaid | MN | |
| 64788HE | Other | MN | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 367142 (Minnesota) | Primary |
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