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211 E Mill St Pelican Rapids MN 56572-4234 | |
(218) 863-6100 | |
(218) 863-6173 |
Full Name | |
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Speciality | Clinic/Center |
Location | 211 E Mill St, Pelican Rapids, 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 | 211 E Mill St Pelican Rapids MN 56572-4234 Ph: (218) 863-6100 |
NPI Number | 1114953627 |
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Provider Enumeration Date | 06/25/2006 |
Last Update Date | 11/29/2022 |
Medicare PECOS PAC ID | 8426967803 |
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Medicare Enrollment ID | O20230127000477 |
Identifier | Type | State | Issuer |
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1114953627 | NPI | - | NPPES |
517494500 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |