| |
2020 Hospital Dr., Ste. 1 Windom MN 56101 | |
(507) 831-1703 | |
(507) 831-5668 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 2020 Hospital Dr., Ste. 1, Windom, Minnesota |
Authorized Official Name and Position | James M Hardwick (CEO) |
Authorized Official Contact | 6052232200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
202 Island Dr Ste 1 Fort Pierre SD 57532-7303 Ph: (605) 223-2200 | 2020 Hospital Dr., Ste. 1 Windom MN 56101 Ph: (507) 831-1703 |
NPI Number | 1174141485 |
---|---|
Provider Enumeration Date | 07/13/2020 |
Last Update Date | 04/22/2021 |
Medicare PECOS PAC ID | 3476447541 |
---|---|
Medicare Enrollment ID | O20200806001222 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174141485 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Sanford Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2170 Hospital Dr, Windom, MN 56101 Phone: 507-831-1422 Fax: 507-831-4783 | |