| Healtheast Cottage Grove Clinic | |
|
6936 Pine Arbor Drive South Suite 100 Cottage Grove MN 55016-3007 | |
| (651) 326-5800 | |
| (651) 326-5802 |
| Full Name | Healtheast Cottage Grove Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 6936 Pine Arbor Drive South, Cottage Grove, Minnesota |
| Authorized Official Name and Position | Doug Davenport (CFO) |
| Authorized Official Contact | 6512322250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healtheast Cottage Grove Clinic 6936 Pine Arbor Drive South Suite 100 Cottage Grove MN 55016-3007 Ph: (651) 326-5800 | Healtheast Cottage Grove Clinic 6936 Pine Arbor Drive South Suite 100 Cottage Grove MN 55016-3007 Ph: (651) 326-5800 |
| NPI Number | 1801842729 |
|---|---|
| Provider Enumeration Date | 05/25/2006 |
| Last Update Date | 05/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801842729 | NPI | - | NPPES |
| 0841630008 | Other | MN | MEDICARE PTAN |
| 543525100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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