| Hennepin County Medical Center | |
|
715 E 78th St Bloomington MN 55420-1397 | |
| (612) 873-7644 | |
| (952) 854-1272 |
| Full Name | Hennepin County Medical Center |
|---|---|
| Speciality | Clinic/center |
| Location | 715 E 78th St, Bloomington, Minnesota |
| Authorized Official Name and Position | Larry A Kryzaniak (CFO) |
| Authorized Official Contact | 6128739290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hennepin County Medical Center 701 Park Ave P1-finance Minneapolis MN 55415-1623 Ph: (612) 873-3000 | Hennepin County Medical Center 715 E 78th St Bloomington MN 55420-1397 Ph: (612) 873-7644 |
| NPI Number | 1730495003 |
|---|---|
| Provider Enumeration Date | 08/25/2010 |
| Last Update Date | 10/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730495003 | NPI | - | NPPES |
| 157245800 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 367063 (Minnesota) | Secondary |
| 261Q00000X | Clinic/center | 367142 (Minnesota) | Primary |
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