| East Side Family Clinic | |
|
895 7th St E Saint Paul MN 55106-3871 | |
| (651) 602-7500 | |
| (651) 602-7513 |
| Full Name | East Side Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 895 7th St E, Saint Paul, Minnesota |
| Authorized Official Name and Position | Reuben Moore (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6516027500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Side Family Clinic 153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 602-7500 | East Side Family Clinic 895 7th St E Saint Paul MN 55106-3871 Ph: (651) 602-7500 |
| NPI Number | 1427106871 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 05/15/2024 |
| Medicare PECOS PAC ID | 2062306434 |
|---|---|
| Medicare Enrollment ID | O20061117000421 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427106871 | NPI | - | NPPES |
| 104017 | Other | MN | UCARE FACILITY ID |
| 377150400 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
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