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3900 Bethel Dr Msc2376 Saint Paul MN 55112-6902 | |
(651) 638-6215 | |
(651) 635-8676 |
Full Name | |
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Speciality | Clinic/center - Student Health |
Location | 3900 Bethel Dr, Saint Paul, Minnesota |
Authorized Official Name and Position | Randy Bergen (EXEC. ASSISTANT TO THE PRESIDENT) |
Authorized Official Contact | 6516386287 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3900 Bethel Dr Msc2376 Saint Paul MN 55112-6902 Ph: (651) 638-6215 | 3900 Bethel Dr Msc2376 Saint Paul MN 55112-6902 Ph: (651) 638-6215 |
NPI Number | 1265857460 |
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Provider Enumeration Date | 02/25/2014 |
Last Update Date | 05/22/2014 |
Identifier | Type | State | Issuer |
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1265857460 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |