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115 W 2nd St Graceville MN 56240-4803 | |
(320) 748-7243 | |
(320) 748-8204 |
Full Name | |
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Speciality | Clinic/Center |
Location | 115 W 2nd St, Graceville, Minnesota |
Authorized Official Name and Position | Alan Hurley (COO) |
Authorized Official Contact | 7013647667 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 157 115 W 2nd St Graceville MN 56240-4803 Ph: (320) 748-7243 | 115 W 2nd St Graceville MN 56240-4803 Ph: (320) 748-7243 |
NPI Number | 1013976281 |
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Provider Enumeration Date | 03/17/2006 |
Last Update Date | 02/29/2024 |
Medicare PECOS PAC ID | 4385556885 |
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Medicare Enrollment ID | O20070305000072 |
Identifier | Type | State | Issuer |
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1013976281 | NPI | - | NPPES |
822523100 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |