| Essentia Health St. Mary's - Pelican Rapids Clinic | |
|
301 N Broadway Pelican Rapids MN 56572-4113 | |
| (218) 863-2000 | |
| Not Available |
| Full Name | Essentia Health St. Mary's - Pelican Rapids Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 N Broadway, Pelican Rapids, Minnesota |
| Authorized Official Name and Position | Alan James 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 - Pelican Rapids Clinic 1027 Washington Ave Detroit Lakes MN 56501-3409 Ph: (218) 863-2000 | Essentia Health St. Mary's - Pelican Rapids Clinic 301 N Broadway Pelican Rapids MN 56572-4113 Ph: (218) 863-2000 |
| NPI Number | 1265876023 |
|---|---|
| Provider Enumeration Date | 04/24/2013 |
| Last Update Date | 03/01/2024 |
| Medicare PECOS PAC ID | 2062326820 |
|---|---|
| Medicare Enrollment ID | O20140916001132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265876023 | NPI | - | NPPES |
| 892442000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Sanford Health Pelican Rapids Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 E Mill St, Pelican Rapids, MN 56572 Phone: 218-863-6100 Fax: 218-863-6173 |