| Essentia Health Chisholm Clinic | |
|
400 Nw 1st Street Chisholm MN 55719-1706 | |
| (218) 254-3391 | |
| Not Available |
| Full Name | Essentia Health Chisholm Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 400 Nw 1st Street, Chisholm, Minnesota |
| Authorized Official Name and Position | Kevin Boren (CFO) |
| Authorized Official Contact | 2187861009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Essentia Health Chisholm Clinic 400 Nw 1st Street Chisholm MN 55719-1706 Ph: (218) 254-3391 | Essentia Health Chisholm Clinic 400 Nw 1st Street Chisholm MN 55719-1706 Ph: (218) 254-3391 |
| NPI Number | 1356389316 |
|---|---|
| Provider Enumeration Date | 06/03/2006 |
| Last Update Date | 11/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356389316 | NPI | - | NPPES |
| 1356389316 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Chisholm Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 1st Ave Sw, Suite 1, Chisholm, MN 55719 Phone: 218-254-7476 |