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615 Nelson Drive Po Box 217 Clearwater MN 55320 | |
(320) 558-2293 | |
(320) 685-4020 |
Full Name | |
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Speciality | Clinic/Center |
Location | 615 Nelson Drive, Clearwater, Minnesota |
Authorized Official Name and Position | Michael A Blair (SR VP & CFO) |
Authorized Official Contact | 3202555665 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1200 6th Ave N Saint Cloud MN 56303-2735 Ph: (320) 252-5131 | 615 Nelson Drive Po Box 217 Clearwater MN 55320 Ph: (320) 558-2293 |
NPI Number | 1255853115 |
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Provider Enumeration Date | 07/12/2017 |
Last Update Date | 11/19/2020 |
Medicare PECOS PAC ID | 2466363395 |
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Medicare Enrollment ID | O20171017001586 |
Identifier | Type | State | Issuer |
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1255853115 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (Minnesota) | Primary |