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123 4th St Nw Bagley MN 56621-8306 | |
(218) 694-2384 | |
(218) 694-6687 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 123 4th St Nw, Bagley, Minnesota |
Authorized Official Name and Position | Nora C. Jennings (ADMIN SECRETARY) |
Authorized Official Contact | 2186946501 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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123 4th St Nw Bagley MN 56621-8306 Ph: (218) 694-2384 | 123 4th St Nw Bagley MN 56621-8306 Ph: (218) 694-2384 |
NPI Number | 1457321176 |
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Provider Enumeration Date | 01/25/2006 |
Last Update Date | 01/27/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457321176 | NPI | - | NPPES |
879685800 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |