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401 12th St N Wheaton MN 56296-1070 | |
(320) 563-8971 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 401 12th St N, Wheaton, 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 | 401 12th St N Wheaton MN 56296-1070 Ph: (320) 563-8971 |
NPI Number | 1245524669 |
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Provider Enumeration Date | 06/02/2011 |
Last Update Date | 11/27/2023 |
Medicare PECOS PAC ID | 8022206663 |
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Medicare Enrollment ID | O20180222001076 |
Identifier | Type | State | Issuer |
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1245524669 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |