| Allina Health Forest Lake Clinic | |
|
1540 Lake St S Forest Lake MN 55025-2628 | |
| (651) 464-7100 | |
| (651) 241-1515 |
| Full Name | Allina Health Forest Lake Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1540 Lake St S, Forest Lake, Minnesota |
| Authorized Official Name and Position | Dominica Tallarico (COO) |
| Authorized Official Contact | 6122222222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allina Health Forest Lake Clinic 2925 Chicago Ave Route 10202 Minneapolis MN 55407-1321 Ph: (612) 262-1166 | Allina Health Forest Lake Clinic 1540 Lake St S Forest Lake MN 55025-2628 Ph: (651) 464-7100 |
| NPI Number | 1447556261 |
|---|---|
| Provider Enumeration Date | 01/27/2011 |
| Last Update Date | 03/21/2024 |
| Medicare PECOS PAC ID | 4587573613 |
|---|---|
| Medicare Enrollment ID | O20120229000829 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447556261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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