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963 South Robert Street West St Paul MN 55118-1446 | |
(651) 451-8050 | |
(651) 552-1575 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 963 South Robert Street, West St Paul, Minnesota |
Authorized Official Name and Position | Brenda Lu Alexander Mccormick (SR. VP AND CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6128136129 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5901 Lincoln Drive, Cbc-2-rev/pe Edina MN 55436-1611 Ph: (952) 992-5691 | 963 South Robert Street West St Paul MN 55118-1446 Ph: (651) 451-8050 |
NPI Number | 1346513447 |
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Provider Enumeration Date | 02/21/2012 |
Last Update Date | 10/31/2022 |
Identifier | Type | State | Issuer |
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1346513447 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Vituity-minnesota, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2000 Oakdale Ave, West St Paul, MN 55118 Phone: 651-554-9500 | |