| Sanford Bemidji Cass Lake Clinic | |
|
219 Grant Utley Avenue Nw Cass Lake MN 56633-0067 | |
| (218) 335-2559 | |
| (218) 335-2755 |
| Full Name | Sanford Bemidji Cass Lake Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 219 Grant Utley Avenue Nw, Cass Lake, Minnesota |
| Authorized Official Name and Position | Martha K Leclerc (VP) |
| Authorized Official Contact | 7012346248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanford Bemidji Cass Lake Clinic 720 4th St N Po Box 2010 Fargo ND 58122-0605 Ph: (218) 335-2559 | Sanford Bemidji Cass Lake Clinic 219 Grant Utley Avenue Nw Cass Lake MN 56633-0067 Ph: (218) 335-2559 |
| NPI Number | 1790710853 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 11/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790710853 | NPI | - | NPPES |
| 961888100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Department Of Human Services &phs, Ihs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 7th St Nw, Cass Lake, MN 56633 Phone: 218-335-3200 | |
Leech Lake Adolescent Outpatient Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 321 2nd St, Cass Lake, MN 56633 Phone: 218-335-8382 Fax: 218-335-3580 | |
Bamenim Anishinabe, Tribal Court Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 6th St Nw Ste E, Cass Lake, MN 56633 Phone: 218-335-4446 Fax: 218-335-3685 | |
Tribal Health/non-ihs Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 115 6th St Ne, Suite E, Cass Lake, MN 56633 Phone: 218-335-4500 Fax: 218-335-4513 | |
Leech Lake Tribal Council Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 115 6th St Ne, Cass Lake, MN 56633 Phone: 218-335-4500 Fax: 218-335-4547 |