Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 115 3rd St, Boyd, Minnesota |
Authorized Official Name and Position | Sara Johnson (BUSINESS OFFICE MGR) |
Authorized Official Contact | 3203122118 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1282 Walnut St Dawson MN 56232-2333 Ph: (320) 769-4393 | 115 3rd St Boyd MN 56218 Ph: (320) 855-2290 |
NPI Number | 1457466716 |
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Provider Enumeration Date | 08/20/2006 |
Last Update Date | 06/20/2018 |
Medicare PECOS PAC ID | 5395653836 |
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Medicare Enrollment ID | O20021029000029 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457466716 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Minnesota) | Primary |