Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 1002 18th Avenue Se, Minot, North Dakota |
Authorized Official Name and Position | Suzanne Hawthorn (COORDINATOR) |
Authorized Official Contact | 9517360137 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
2370 Anselmo Dr Corona CA 92879-7106 Ph: (951) 736-0137 | 1002 18th Avenue Se Minot ND 58701 Ph: (951) 736-0137 |
NPI Number | 1669216974 |
---|---|
Provider Enumeration Date | 06/21/2024 |
Last Update Date | 10/11/2024 |
Medicare PECOS PAC ID | 3678008331 |
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Medicare Enrollment ID | O20241119001636 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669216974 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (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 |