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19120 200th St Greenbush MN 56726-9280 | |
(218) 782-2400 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 19120 200th St, Greenbush, Minnesota |
Authorized Official Name and Position | Derek Goebel (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7017801470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 13780 Grand Forks ND 58208-3780 Ph: (701) 780-5000 | 19120 200th St Greenbush MN 56726-9280 Ph: (218) 782-2400 |
NPI Number | 1962591438 |
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Provider Enumeration Date | 10/12/2006 |
Last Update Date | 05/23/2024 |
Identifier | Type | State | Issuer |
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1962591438 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |