| Welia Health Pine City | |
|
1425 Main Street North Pine City MN 55063-1530 | |
| (320) 629-7505 | |
| (320) 629-2202 |
| Full Name | Welia Health Pine City |
|---|---|
| Speciality | Clinic/Center |
| Location | 1425 Main Street North, Pine City, Minnesota |
| Authorized Official Name and Position | Randy Ulseth (CEO) |
| Authorized Official Contact | 3206791212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Welia Health Pine City 301 Highway 65 S Mora MN 55051-1899 Ph: (320) 679-1212 | Welia Health Pine City 1425 Main Street North Pine City MN 55063-1530 Ph: (320) 629-7505 |
| NPI Number | 1992012207 |
|---|---|
| Provider Enumeration Date | 09/08/2010 |
| Last Update Date | 07/20/2021 |
| Medicare PECOS PAC ID | 6709295496 |
|---|---|
| Medicare Enrollment ID | O20210514001969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992012207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Minnesota) | Primary |
| Provider Name | Elizabeth M Godin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780798207 PECOS PAC ID: 7214947340 Enrollment ID: I20060503000431 |
| Provider Name | Ethan T Kraft |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316471386 PECOS PAC ID: 0244599587 Enrollment ID: I20220614000484 |
| Provider Name | Laura Lara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942881412 PECOS PAC ID: 0840695979 Enrollment ID: I20231026003830 |
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