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1200 Grant Blvd W Wabasha MN 55981-1042 | |
(651) 565-5600 | |
(651) 565-5670 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1200 Grant Blvd W, Wabasha, Minnesota |
Authorized Official Name and Position | John K Wolfe (CFO) |
Authorized Official Contact | 6515655553 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1200 Grant Blvd W Wabasha MN 55981-1042 Ph: (651) 565-5600 | 1200 Grant Blvd W Wabasha MN 55981-1042 Ph: (651) 565-5600 |
NPI Number | 1477068914 |
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Provider Enumeration Date | 12/06/2017 |
Last Update Date | 03/16/2023 |
Medicare PECOS PAC ID | 5092619387 |
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Medicare Enrollment ID | O20171215000803 |
Identifier | Type | State | Issuer |
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1477068914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |