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601 Hwy 73 Box 46 Floodwood MN 55736-0046 | |
(218) 476-2969 | |
(218) 476-1599 |
Full Name | |
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Speciality | Clinic/center |
Location | 601 Hwy 73, Floodwood, Minnesota |
Authorized Official Name and Position | Michael A Holmes (CEO) |
Authorized Official Contact | 2186665102 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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601 Hwy 73 Box 46 Floodwood MN 55736-0046 Ph: (218) 476-2969 | 601 Hwy 73 Box 46 Floodwood MN 55736-0046 Ph: (218) 476-2969 |
NPI Number | 1699748533 |
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Provider Enumeration Date | 02/10/2006 |
Last Update Date | 03/03/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699748533 | NPI | - | NPPES |
366254300 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | N/A (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |