Randall Lakes Area Clinic | |
250 White Oak Drive Randall MN 56475 | |
(320) 749-2877 | |
Not Available |
Full Name | Randall Lakes Area Clinic |
---|---|
Speciality | Clinic/Center |
Location | 250 White Oak Drive, Randall, Minnesota |
Authorized Official Name and Position | Steven S. Smith (VICE PRESIDENT OF FINANCE) |
Authorized Official Contact | 3206315670 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Randall Lakes Area Clinic 250 White Oak Drive Randall MN 56475 Ph: (320) 749-2877 | Randall Lakes Area Clinic 250 White Oak Drive Randall MN 56475 Ph: (320) 749-2877 |
NPI Number | 1336359009 |
---|---|
Provider Enumeration Date | 05/23/2007 |
Last Update Date | 11/28/2012 |
Medicare PECOS PAC ID | 9830003516 |
---|---|
Medicare Enrollment ID | O20090817000153 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336359009 | NPI | - | NPPES |
640K9RA | Other | MN | BCBSM |
040760700 | Medicaid | MN | |
24-3447 | Other | MN | RHC PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |