| Aazhoomog Clinic | |
|
45741 Grace Lake Road Sandstone MN 55072-3203 | |
| (320) 384-0149 | |
| (320) 384-0916 |
| Full Name | Aazhoomog Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 45741 Grace Lake Road, Sandstone, Minnesota |
| Authorized Official Name and Position | Nicole Anderson (COMMISSIONER OF HEALTH & HUMAN SERV) |
| Authorized Official Contact | 3205324163 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aazhoomog Clinic 18562 Minobimaadizi Loop Onamia MN 56359 Ph: (320) 532-4163 | Aazhoomog Clinic 45741 Grace Lake Road Sandstone MN 55072-3203 Ph: (320) 384-0149 |
| NPI Number | 1831385509 |
|---|---|
| Provider Enumeration Date | 09/17/2007 |
| Last Update Date | 08/10/2020 |
| Certification Date | 08/10/2020 |
| Medicare PECOS PAC ID | 5991869471 |
|---|---|
| Medicare Enrollment ID | O20090128000174 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831385509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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