Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 102 Farwell St S, Verndale, Minnesota |
Authorized Official Name and Position | Joel W Beiswenger (CEO) |
Authorized Official Contact | 2186317489 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
415 Jefferson St N Wadena MN 56482-1264 Ph: (218) 631-3510 | 102 Farwell St S Verndale MN 56481 Ph: (218) 445-5990 |
NPI Number | 1407262405 |
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Provider Enumeration Date | 07/10/2014 |
Last Update Date | 02/03/2023 |
Medicare PECOS PAC ID | 2961395272 |
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Medicare Enrollment ID | O20141216001006 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407262405 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |