| Healthsource Of St. Paul- Grand | |
|
1053 Grand Ave Suite #114 Saint Paul MN 55105-3022 | |
| (651) 292-9247 | |
| (651) 292-9257 |
| Full Name | Healthsource Of St. Paul- Grand |
|---|---|
| Speciality | Clinic/Center |
| Location | 1053 Grand Ave, Saint Paul, Minnesota |
| Authorized Official Name and Position | Christopher Thomas Drews (PRESIDENT) |
| Authorized Official Contact | 6512929247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of St. Paul- Grand 1053 Grand Ave Suite #114 Saint Paul MN 55105-3022 Ph: (651) 292-9247 | Healthsource Of St. Paul- Grand 1053 Grand Ave Suite #114 Saint Paul MN 55105-3022 Ph: (651) 292-9247 |
| NPI Number | 1154696813 |
|---|---|
| Provider Enumeration Date | 03/14/2012 |
| Last Update Date | 03/30/2012 |
| Medicare PECOS PAC ID | 5496985962 |
|---|---|
| Medicare Enrollment ID | O20140228001113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154696813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC4257 (Minnesota) | Primary |
| Provider Name | Bethany Ann Fluto |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811357528 PECOS PAC ID: 4183921158 Enrollment ID: I20160318001843 |
Saint Paul Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 Saint Clair Ave, Saint Paul, MN 55105 Phone: 651-291-1269 Fax: 651-291-0957 | |
Guadalupe Alternative Program(gap) Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 381 Robie St E, Saint Paul, MN 55107 Phone: 651-602-7976 Fax: 651-602-7977 | |
East Metro - North St. Paul Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 Centennial Dr, Suite 100, Saint Paul, MN 55109 Phone: 651-777-7414 Fax: 651-748-5839 | |
Family Health & Wellness Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4520 Centerville Rd, Saint Paul, MN 55127 Phone: 651-348-8851 | |
Metropolitan Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17 Exchange St W, Suite # 420, Saint Paul, MN 55102 Phone: 651-232-4125 Fax: 651-232-4127 | |
Central High School Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 275 Lexington Pkwy N, Saint Paul, MN 55104 Phone: 651-632-2194 Fax: 651-632-2195 | |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |