| |
1601 St Francis Ave Ste 100 Shakopee MN 55379-3387 | |
(952) 428-3535 | |
(952) 428-3599 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1601 St Francis Ave, Shakopee, Minnesota |
Authorized Official Name and Position | Dominica Tallarico (COO) |
Authorized Official Contact | 6122222222 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 43 Mail Route 10585 Minneapolis MN 55440-0043 Ph: (612) 262-1166 | 1601 St Francis Ave Ste 100 Shakopee MN 55379-3387 Ph: (952) 428-3535 |
NPI Number | 1477859486 |
---|---|
Provider Enumeration Date | 02/09/2011 |
Last Update Date | 01/23/2025 |
Medicare PECOS PAC ID | 4587573613 |
---|---|
Medicare Enrollment ID | O20120302000287 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477859486 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
St Francis Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1455 Saint Francis Ave, Shakopee, MN 55379 Phone: 952-428-3000 |