| Hennepin County | |
|
2220 Plymouth Ave N Minneapolis MN 55411-3047 | |
| (612) 543-2500 | |
| (612) 302-4870 |
| Full Name | Hennepin County |
|---|---|
| Speciality | Clinic/Center |
| Location | 2220 Plymouth Ave N, 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 2220 Plymouth Ave N Minneapolis MN 55411-3047 Ph: (612) 543-2500 | Hennepin County 2220 Plymouth Ave N Minneapolis MN 55411-3047 Ph: (612) 543-2500 |
| NPI Number | 1215951751 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 02/14/2023 |
| Medicare PECOS PAC ID | 7911892849 |
|---|---|
| Medicare Enrollment ID | O20050919000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215951751 | NPI | - | NPPES |
| 9594810 | Other | MN | PREFERRED ONE |
| 7700677 | Other | MN | METROPOLITAN HEALTH PLAN |
| 87621 | Other | MN | HEALTH PARTNERS |
| 106809 | Other | MN | UCARE |
| 1215951751 | Medicaid | MN | |
| 13838PI | Other | MD | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
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