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131 Birch Avenue Hector MN 55342-0117 | |
(320) 848-6294 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 131 Birch Avenue, Hector, Minnesota |
Authorized Official Name and Position | Nathan Blad (PRESIDENT) |
Authorized Official Contact | 3205233575 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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100 Healthy Way Olivia MN 56277-1114 Ph: (320) 523-1261 | 131 Birch Avenue Hector MN 55342-0117 Ph: (320) 848-6294 |
NPI Number | 1578736492 |
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Provider Enumeration Date | 04/11/2008 |
Last Update Date | 05/01/2020 |
Medicare PECOS PAC ID | 5890126726 |
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Medicare Enrollment ID | O20200514002436 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578736492 | NPI | - | NPPES |
24-3443 | Other | MN | MEDICARE CCN / CERTIFICAT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |