| Hennepin County | |
|
800 W Broadway Ave Minneapolis MN 55411-2614 | |
| (612) 543-2900 | |
| (612) 288-2909 |
| Full Name | Hennepin County |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 W Broadway Ave, Minneapolis, Minnesota |
| Authorized Official Name and Position | Brian James Bergs (CFO) |
| Authorized Official Contact | 6125432545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hennepin County 1313 Penn Ave N Minneapolis MN 55411-3047 Ph: (612) 543-2500 | Hennepin County 800 W Broadway Ave Minneapolis MN 55411-2614 Ph: (612) 543-2900 |
| NPI Number | 1154774925 |
|---|---|
| Provider Enumeration Date | 07/18/2016 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7911892849 |
|---|---|
| Medicare Enrollment ID | O20160824001402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154774925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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