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410 4th St Nw Mahnomen MN 56557-4208 | |
(218) 935-2514 | |
(218) 935-2720 |
Full Name | |
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Speciality | Clinic/Center |
Location | 410 4th St Nw, Mahnomen, Minnesota |
Authorized Official Name and Position | Tony Lee Morrison (VICE PRESIDENT, REVENUE CYCLE) |
Authorized Official Contact | 6053288380 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2168 Fargo ND 58107-2168 Ph: (701) 234-2119 | 410 4th St Nw Mahnomen MN 56557-4208 Ph: (218) 935-2514 |
NPI Number | 1831131234 |
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Provider Enumeration Date | 06/11/2006 |
Last Update Date | 11/29/2022 |
Medicare PECOS PAC ID | 8426967803 |
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Medicare Enrollment ID | O20230207001753 |
Identifier | Type | State | Issuer |
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1831131234 | NPI | - | NPPES |
954222100 | Medicaid | MN |