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1501 Aldrich Ave N Minneapolis MN 55411-3335 | |
(612) 668-2486 | |
(612) 668-2600 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1501 Aldrich Ave N, Minneapolis, Minnesota |
Authorized Official Name and Position | Baye D Diouf (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 6125432545 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1256 Penn Ave N Ste 5100 Minneapolis MN 55411-2617 Ph: (612) 543-2500 | 1501 Aldrich Ave N Minneapolis MN 55411-3335 Ph: (612) 668-2486 |
NPI Number | 1447619929 |
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Provider Enumeration Date | 02/12/2016 |
Last Update Date | 09/24/2024 |
Medicare PECOS PAC ID | 7911892849 |
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Medicare Enrollment ID | O20170309000187 |
Identifier | Type | State | Issuer |
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1447619929 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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