| Como High School | |
|
740 Rose Ave W Saint Paul MN 55117-4042 | |
| (651) 487-8539 | |
| (651) 487-8536 |
| Full Name | Como High School |
|---|---|
| Speciality | Clinic/Center |
| Location | 740 Rose Ave W, Saint Paul, Minnesota |
| Authorized Official Name and Position | Reuben Moore (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6516027536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Como High School 153 Cesar Chavez St Saint Paul MN 55107-2226 Ph: (651) 602-7500 | Como High School 740 Rose Ave W Saint Paul MN 55117-4042 Ph: (651) 487-8539 |
| NPI Number | 1932392727 |
|---|---|
| Provider Enumeration Date | 08/24/2007 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Medicare PECOS PAC ID | 2062306434 |
|---|---|
| Medicare Enrollment ID | O20061117000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932392727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Minnesota) | Primary |
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