| Trucare Clinic Llc | |
|
1527 E Lake St Ste 1 Minneapolis MN 55407-6700 | |
| (267) 475-3076 | |
| Not Available |
| Full Name | Trucare Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1527 E Lake St Ste 1, Minneapolis, Minnesota |
| Authorized Official Name and Position | Mohamed Abdullahi (PRESIDENT) |
| Authorized Official Contact | 6124775521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trucare Clinic Llc 1527 E Lake St Ste 1 Minneapolis MN 55407-6700 Ph: (612) 345-7175 | Trucare Clinic Llc 1527 E Lake St Ste 1 Minneapolis MN 55407-6700 Ph: (267) 475-3076 |
| NPI Number | 1073257572 |
|---|---|
| Provider Enumeration Date | 04/21/2022 |
| Last Update Date | 04/07/2023 |
| Medicare PECOS PAC ID | 6901274604 |
|---|---|
| Medicare Enrollment ID | O20221201000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073257572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mohamed Abdulcadir Abdullahi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437475431 PECOS PAC ID: 8921227208 Enrollment ID: I20190514000521 |
| Provider Name | Queen Gbor Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871127860 PECOS PAC ID: 0143659870 Enrollment ID: I20200401001499 |
| Provider Name | Leonelle Yoke Ebanja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538577499 PECOS PAC ID: 3870912314 Enrollment ID: I20201001002098 |
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