Full Name | |
---|---|
Speciality | Clinic/center |
Location | 20 5th St Se, Cook, Minnesota |
Authorized Official Name and Position | Michael A Holmes (CE) |
Authorized Official Contact | 2186665941 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
20 5th St Se Cook MN 55723-9702 Ph: (218) 666-5941 | 20 5th St Se Cook MN 55723-9702 Ph: (218) 666-5941 |
NPI Number | 1538132774 |
---|---|
Provider Enumeration Date | 02/08/2006 |
Last Update Date | 03/03/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538132774 | NPI | - | NPPES |
366254300 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | N/A (Minnesota) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Bridge To Health, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1817 Highway 53, Cook, MN 55723 Phone: 218-208-7502 | |