| Sanny And Jerry Ryan Center For Prevention And Genetics | |
|
4401 S 11th St Ste 1000 Grand Forks ND 58201-7238 | |
| (701) 780-7620 | |
| Not Available |
| Full Name | Sanny And Jerry Ryan Center For Prevention And Genetics |
|---|---|
| Speciality | Clinic/Center |
| Location | 4401 S 11th St Ste 1000, Grand Forks, North Dakota |
| Authorized Official Name and Position | Derek Goebel (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7017801470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanny And Jerry Ryan Center For Prevention And Genetics Po Box 13780 Grand Forks ND 58208-3780 Ph: (701) 780-1500 | Sanny And Jerry Ryan Center For Prevention And Genetics 4401 S 11th St Ste 1000 Grand Forks ND 58201-7238 Ph: (701) 780-7620 |
| NPI Number | 1811617103 |
|---|---|
| Provider Enumeration Date | 08/29/2022 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 1355251604 |
|---|---|
| Medicare Enrollment ID | O20230315001460 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811617103 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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