| Essentia Health St. Joseph's-pine River Clinic | |
|
280 Barclay Ave W Pine River MN 56474-5197 | |
| (218) 587-4416 | |
| (218) 587-2677 |
| Full Name | Essentia Health St. Joseph's-pine River Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 280 Barclay Ave W, Pine River, Minnesota |
| Authorized Official Name and Position | Kevin Boren (VP OF FINANCE) |
| Authorized Official Contact | 2187861009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Essentia Health St. Joseph's-pine River Clinic 280 Barclay Ave W Pine River MN 56474-5197 Ph: (218) 587-4416 | Essentia Health St. Joseph's-pine River Clinic 280 Barclay Ave W Pine River MN 56474-5197 Ph: (218) 587-4416 |
| NPI Number | 1649223603 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 02/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649223603 | NPI | - | NPPES |
| 699019300 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 330736 (Minnesota) | Primary |
Central Minnesota Dermatology, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 415 Barclay Ave, Pine River, MN 56474 Phone: 218-454-3376 Fax: 218-454-4263 |