| Lakewood Health Center Rhc | |
|
600 Main Ave S Baudette MN 56623-2855 | |
| (218) 634-1655 | |
| (218) 634-1094 |
| Full Name | Lakewood Health Center Rhc |
|---|---|
| Speciality | Clinic/Center |
| Location | 600 Main Ave S, Baudette, Minnesota |
| Authorized Official Name and Position | Jeffry A Stampohar (PRESIDENT) |
| Authorized Official Contact | 2186342120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Health Center Rhc 600 Main Ave S Baudette MN 56623-2855 Ph: (218) 634-1655 | Lakewood Health Center Rhc 600 Main Ave S Baudette MN 56623-2855 Ph: (218) 634-1655 |
| NPI Number | 1659511335 |
|---|---|
| Provider Enumeration Date | 02/20/2009 |
| Last Update Date | 02/27/2020 |
| Medicare PECOS PAC ID | 5698687929 |
|---|---|
| Medicare Enrollment ID | O20101103000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659511335 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Justin Quo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285947556 PECOS PAC ID: 9931342714 Enrollment ID: I20130826001067 |
| Provider Name | Wade Sendelbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033548854 PECOS PAC ID: 1355676909 Enrollment ID: I20220621001545 |
| Provider Name | Sharon Falke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578591947 PECOS PAC ID: 8527024264 Enrollment ID: I20231024003575 |
Chi Lakewood Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Main Ave S, Baudette, MN 56623 Phone: 218-634-1655 Fax: 218-634-1094 |