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42 E. Main St. Dodge Center MN 55927 | |
(507) 635-6150 | |
(507) 633-9601 |
Full Name | |
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Speciality | Clinic/Center |
Location | 42 E. Main St., Dodge Center, Minnesota |
Authorized Official Name and Position | Amy Evans (DIRECTOR OF PUBLIC HEALTH) |
Authorized Official Contact | 5076356150 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 129 42 E Main St. Dodge Center MN 55927 Ph: (507) 635-6150 | 42 E. Main St. Dodge Center MN 55927 Ph: (507) 635-6150 |
NPI Number | 1619002680 |
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Provider Enumeration Date | 02/22/2007 |
Last Update Date | 05/12/2022 |
Medicare PECOS PAC ID | 5799685384 |
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Medicare Enrollment ID | O20070716000522 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619002680 | NPI | - | NPPES |
458353100 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261QP0905X | Clinic/center - Public Health, State Or Local | 8026557 (Minnesota) | Primary |