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19120 200th St Ste 100 Greenbush MN 56726-9280 | |
(218) 782-2400 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 19120 200th St Ste 100, Greenbush, Minnesota |
Authorized Official Name and Position | Catherine A Huss (CFO) |
Authorized Official Contact | 2184632500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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715 Delmore Dr Roseau MN 56751-1599 Ph: (218) 463-2500 | 19120 200th St Ste 100 Greenbush MN 56726-9280 Ph: (218) 782-2400 |
NPI Number | 1558118919 |
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Provider Enumeration Date | 05/03/2024 |
Last Update Date | 06/18/2024 |
Medicare PECOS PAC ID | 4789586884 |
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Medicare Enrollment ID | O20240803000095 |
Identifier | Type | State | Issuer |
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1558118919 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |