| Healtheast Maplewood Clinic | |
|
2945 Hazelwood St Ste 100 Maplewood MN 55109 | |
| (651) 232-7800 | |
| (651) 232-7826 |
| Full Name | Healtheast Maplewood Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 2945 Hazelwood St Ste 100, 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 |
|---|---|
| Healtheast Maplewood Clinic 2945 Hazelwood St Ste 100 Maplewood MN 55109-1242 Ph: (651) 232-7800 | Healtheast Maplewood Clinic 2945 Hazelwood St Ste 100 Maplewood MN 55109 Ph: (651) 232-7800 |
| NPI Number | 1689616716 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 10/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689616716 | NPI | - | NPPES |
| 640716100 | Medicaid | MN | |
| 0841630011 | Other | MN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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