| Lakewood Clinic Staples | |
|
49725 County 83 Staples MN 56479-5280 | |
| (218) 894-1515 | |
| (218) 898-7596 |
| Full Name | Lakewood Clinic Staples |
|---|---|
| Speciality | Clinic/Center |
| Location | 49725 County 83, Staples, Minnesota |
| Authorized Official Name and Position | Craig Wolhowe (VICE PRESIDENT) |
| Authorized Official Contact | 2188948600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakewood Clinic Staples 49725 County 83 Staples MN 56479-5280 Ph: (218) 894-1515 | Lakewood Clinic Staples 49725 County 83 Staples MN 56479-5280 Ph: (218) 894-1515 |
| NPI Number | 1841280823 |
|---|---|
| Provider Enumeration Date | 10/21/2005 |
| Last Update Date | 05/22/2017 |
| Medicare PECOS PAC ID | 1052229671 |
|---|---|
| Medicare Enrollment ID | O20021018000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841280823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 727 (Minnesota) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
St Joseph's Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 2nd Ave Nw, Staples, MN 56479 Phone: 218-894-7870 Fax: 218-894-7879 |