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1675 Beam Ave Ste 200 Maplewood MN 55109-1479 | |
(651) 779-2200 | |
(651) 779-9989 |
Full Name | |
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Speciality | Clinic/center |
Location | 1675 Beam Ave Ste 200, Maplewood, Minnesota |
Authorized Official Name and Position | Maureen Ring (DIRECTOR NETWORK RELATIONS AO) |
Authorized Official Contact | 6126726740 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 147 Minneapolis MN 55440-0147 Ph: (612) 672-6724 | 1675 Beam Ave Ste 200 Maplewood MN 55109-1479 Ph: (651) 779-2200 |
NPI Number | 1285809590 |
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Provider Enumeration Date | 04/28/2008 |
Last Update Date | 10/04/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285809590 | NPI | - | NPPES |
758355900 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Polaris Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2053 Woodlynn Ave, Maplewood, MN 55109 Phone: 651-431-0047 | |
My Medical Clinic Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1560 Beam Ave, Maplewood, MN 55109 Phone: 651-484-6923 |