| Essentia Health St. Mary's - Mahnomen Clinic | |
|
117 N Main St Mahnomen MN 56557-4003 | |
| (218) 936-5616 | |
| Not Available |
| Full Name | Essentia Health St. Mary's - Mahnomen Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 117 N Main St, Mahnomen, 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 |
|---|---|
| Essentia Health St. Mary's - Mahnomen Clinic 1027 Washington Ave Detroit Lakes MN 56501-3409 Ph: (218) 847-5611 | Essentia Health St. Mary's - Mahnomen Clinic 117 N Main St Mahnomen MN 56557-4003 Ph: (218) 936-5616 |
| NPI Number | 1750725586 |
|---|---|
| Provider Enumeration Date | 04/23/2013 |
| Last Update Date | 03/01/2024 |
| Medicare PECOS PAC ID | 2062326820 |
|---|---|
| Medicare Enrollment ID | O20111209000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750725586 | NPI | - | NPPES |
| 892442000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dakota Clinic, Ltd. - Mahnomen Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 N Main St, Mahnomen, MN 56557 Phone: 218-936-5616 Fax: 218-936-5619 | |
White Earth Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2471 310th Ave, Mahnomen, MN 56557 Phone: 218-935-2238 Fax: 218-935-5085 | |
Sanford Health Mahnomen Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 4th St Nw, Mahnomen, MN 56557 Phone: 218-935-2514 Fax: 218-935-2720 |