| Hennepin County | |
|
1009 E 14th St Minneapolis MN 55404-1314 | |
| (612) 348-5553 | |
| Not Available |
| Full Name | Hennepin County |
|---|---|
| Speciality | Clinic/Center |
| Location | 1009 E 14th St, Minneapolis, Minnesota |
| Authorized Official Name and Position | Stephanie Abel (AREA MANAGER) |
| Authorized Official Contact | 6123488824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hennepin County 525 Portland Ave # Mc963 Minneapolis MN 55415-1533 Ph: (612) 348-5553 | Hennepin County 1009 E 14th St Minneapolis MN 55404-1314 Ph: (612) 348-5553 |
| NPI Number | 1962147413 |
|---|---|
| Provider Enumeration Date | 04/29/2022 |
| Last Update Date | 05/18/2022 |
| Medicare PECOS PAC ID | 7911892849 |
|---|---|
| Medicare Enrollment ID | O20221010001050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962147413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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