| |
202 South County Road 33 Winthrop MN 55396 | |
(507) 647-5318 | |
(507) 647-2118 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 202 South County Road 33, Winthrop, Minnesota |
Authorized Official Name and Position | Michael Phelps (PRESIDENT/CEO) |
Authorized Official Contact | 9524422191 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
601 W Chandler St P.o. Box 620 Arlington MN 55307-2127 Ph: (507) 964-2271 | 202 South County Road 33 Winthrop MN 55396 Ph: (507) 647-5318 |
NPI Number | 1598725905 |
---|---|
Provider Enumeration Date | 03/28/2006 |
Last Update Date | 04/20/2022 |
Medicare PECOS PAC ID | 3870722499 |
---|---|
Medicare Enrollment ID | O20140203000049 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598725905 | NPI | - | NPPES |
248648200 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Minnesota) | Primary |