| Hendricks Clinic Pa | |
|
501 E Lincoln St Hendricks MN 56136-0026 | |
| (507) 275-3121 | |
| (507) 275-3194 |
| Full Name | Hendricks Clinic Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 501 E Lincoln St, Hendricks, Minnesota |
| Authorized Official Name and Position | Tabb L Mccluskey (OWNER PRESIDENT) |
| Authorized Official Contact | 5072753121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hendricks Clinic Pa 501 E Lincoln St Po Box 26 Hendricks MN 56136-0026 Ph: (507) 275-3121 | Hendricks Clinic Pa 501 E Lincoln St Hendricks MN 56136-0026 Ph: (507) 275-3121 |
| NPI Number | 1104850510 |
|---|---|
| Provider Enumeration Date | 07/10/2006 |
| Last Update Date | 12/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104850510 | NPI | - | NPPES |
| 232816000 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | 1757969 (Minnesota) | Secondary |
Hendricks Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 501 E Lincoln St, Hendricks, MN 56136 Phone: 507-275-3121 Fax: 507-275-3194 |