| |
1600 2nd Ave Sw Ste 19 Minot ND 58701 | |
(701) 448-2054 | |
(701) 448-2056 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1600 2nd Ave Sw Ste 19, Minot, North Dakota |
Authorized Official Name and Position | Rachel Thomas (CFO) |
Authorized Official Contact | 7014482054 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 535 Turtle Lake ND 58575-0535 Ph: (701) 448-2054 | 1600 2nd Ave Sw Ste 19 Minot ND 58701 Ph: (701) 448-2054 |
NPI Number | 1588906770 |
---|---|
Provider Enumeration Date | 03/26/2013 |
Last Update Date | 02/18/2021 |
Medicare PECOS PAC ID | 1557270113 |
---|---|
Medicare Enrollment ID | O20140204000565 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588906770 | NPI | - | NPPES |
5923 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mckenzie County Healthcare Systems Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 18th Ave Se, Minot, ND 58701 Phone: 701-852-6143 Fax: 701-842-4025 | |
Minot State University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 University Ave W, Student Health Center, Minot, ND 58707 Phone: 701-858-3371 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3520 N Broadway, Minot, ND 58703 Phone: 877-522-1275 Fax: 509-491-3031 |