| Cdp Health Care System-browns Valley Clinic | |
|
404 West Broadway Browns Valley MN 56219 | |
| (320) 695-2526 | |
| (320) 695-2106 |
| Full Name | Cdp Health Care System-browns Valley Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 404 West Broadway, Browns Valley, Minnesota |
| Authorized Official Name and Position | Greg A. Weaver (INTERIM CEO) |
| Authorized Official Contact | 6056987647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cdp Health Care System-browns Valley Clinic 205 Orchard Dr Sisseton SD 57262-2398 Ph: (605) 698-7681 | Cdp Health Care System-browns Valley Clinic 404 West Broadway Browns Valley MN 56219 Ph: (320) 695-2526 |
| NPI Number | 1255477162 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/27/2018 |
| Medicare PECOS PAC ID | 8022926468 |
|---|---|
| Medicare Enrollment ID | O20080401000657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255477162 | NPI | - | NPPES |
| 5160 | Medicaid | ND | |
| 49082CO | Other | MN | BLUE CROSS |
| 03070116200 | Other | PRIMEWEST | |
| 05160 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 60020 (South Dakota) | Primary |
| 261QR1300X | Clinic/center - Rural Health | 60020 (South Dakota) | Secondary |
| Provider Name | Stanley C Gallagher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831125657 PECOS PAC ID: 4385552504 Enrollment ID: I20060320000295 |
| Provider Name | Angela K Gaikowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275788960 PECOS PAC ID: 9032339510 Enrollment ID: I20141126000055 |