Proactive Healthcare | |
101 5th St E Suite 227 Saint Paul MN 55101-1898 | |
(651) 778-0080 | |
(651) 778-0195 |
Full Name | Proactive Healthcare |
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Speciality | General Practice |
Location | 101 5th St E, Saint Paul, Minnesota |
Authorized Official Name and Position | Nathan Burdash (C.E.O.) |
Authorized Official Contact | 6517780080 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Proactive Healthcare 101 5th St E Suite 227 Saint Paul MN 55101-1898 Ph: (651) 778-0080 | Proactive Healthcare 101 5th St E Suite 227 Saint Paul MN 55101-1898 Ph: (651) 778-0080 |
NPI Number | 1891058384 |
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Provider Enumeration Date | 06/19/2012 |
Last Update Date | 09/27/2012 |
Medicare PECOS PAC ID | 0143477521 |
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Medicare Enrollment ID | O20120821000425 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891058384 | NPI | - | NPPES |
1891058384 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 41988 (Minnesota) | Primary |
Provider Name | Nathan M Burdash |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1861553588 PECOS PAC ID: 9638247364 Enrollment ID: I20081008000644 |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |