| Cedar Riverside People's Center | |
|
425 20th Avenue South Minneapolis MN 55454-4400 | |
| (612) 332-4973 | |
| (612) 238-3534 |
| Full Name | Cedar Riverside People's Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 425 20th Avenue South, Minneapolis, Minnesota |
| Authorized Official Name and Position | Raul Noriega (DIR. OF HIT AND BILLING) |
| Authorized Official Contact | 6123324973 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Riverside People's Center 425 20th Avenue South Minneapolis MN 55454-4400 Ph: (612) 332-4973 | Cedar Riverside People's Center 425 20th Avenue South Minneapolis MN 55454-4400 Ph: (612) 332-4973 |
| NPI Number | 1548340813 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 02/07/2018 |
| Medicare PECOS PAC ID | 8325959505 |
|---|---|
| Medicare Enrollment ID | O20030913000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548340813 | NPI | - | NPPES |
| 655853400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 6075748 (Minnesota) | Primary |
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