St. Paul Family Medical Center | |
1239 Payne Ave Saint Paul MN 55130 | |
(651) 209-8350 | |
Not Available |
Full Name | St. Paul Family Medical Center |
---|---|
Speciality | Clinic/Center |
Location | 1239 Payne Ave, Saint Paul, Minnesota |
Authorized Official Name and Position | Phua Xiong (PRESIDENT) |
Authorized Official Contact | 6512098350 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
St. Paul Family Medical Center 1239 Payne Ave Saint Paul MN 55130 Ph: (651) 209-8350 | St. Paul Family Medical Center 1239 Payne Ave Saint Paul MN 55130 Ph: (651) 209-8350 |
NPI Number | 1346302981 |
---|---|
Provider Enumeration Date | 12/13/2006 |
Last Update Date | 10/17/2016 |
Medicare PECOS PAC ID | 4789756859 |
---|---|
Medicare Enrollment ID | O20080707000343 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346302981 | NPI | - | NPPES |
01-09122 | Other | MN | MEDICA |
489369700 | Medicaid | MN | |
G174 | Other | MN | PATIENT CHOICE |
83934 | Other | MN | HEALTHPARTNERS |
156J3ST | Other | MN | BLUE CROSS BLUE SHIELD |
170453 | Other | MN | UCARE MINNESOTA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 1571 (Minnesota) | Primary |
Provider Name | Phua Xiong |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720149347 PECOS PAC ID: 4981791662 Enrollment ID: I20071026000550 |
Premiere Mental Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St Ste 290, Saint Paul, MN 55102 Phone: 763-913-8125 |