| |
101 Main St S Ste 115 Le Sueur MN 56058-7503 | |
(507) 665-3301 | |
Not Available |
Full Name | |
---|---|
Speciality | Pharmacy |
Location | 101 Main St S Ste 115, Le Sueur, Minnesota |
Authorized Official Name and Position | Tina Miller (EXECUTIVE ASSISTANT) |
Authorized Official Contact | 5074347425 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
905 N Main St Austin MN 55912-3357 Ph: (507) 433-7447 | 101 Main St S Ste 115 Le Sueur MN 56058-7503 Ph: (507) 665-3301 |
NPI Number | 1114409257 |
---|---|
Provider Enumeration Date | 09/05/2018 |
Last Update Date | 12/10/2024 |
Medicare PECOS PAC ID | 7810993623 |
---|---|
Medicare Enrollment ID | O20181130000060 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114409257 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
3336C0003X | Pharmacy - Community/retail Pharmacy | (* (Not Available)) | Primary |
Minnesota Valley Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 621 S 4th St, Le Sueur, MN 56058 Phone: 507-665-3375 Fax: 507-665-2191 | |