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1010 S Birch Ave Box 700 Hallock MN 56728-4215 | |
(218) 843-3612 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1010 S Birch Ave, Hallock, Minnesota |
Authorized Official Name and Position | Jeni Schwenzfeier (CFO) |
Authorized Official Contact | 2188433802 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1010 S Birch Ave Box 700 Hallock MN 56728-4215 Ph: (218) 843-3612 | 1010 S Birch Ave Box 700 Hallock MN 56728-4215 Ph: (218) 843-3612 |
NPI Number | 1740359348 |
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Provider Enumeration Date | 11/07/2006 |
Last Update Date | 02/12/2020 |
Medicare PECOS PAC ID | 1355251315 |
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Medicare Enrollment ID | O20100721000385 |
Identifier | Type | State | Issuer |
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1740359348 | NPI | - | NPPES |
517325600 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |