| Med Cell Regenerate, Llc | |
|
7373 Kirkwood Ct N Ste 110 Maple Grove MN 55369-5211 | |
| (763) 898-3517 | |
| Not Available |
| Full Name | Med Cell Regenerate, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7373 Kirkwood Ct N Ste 110, Maple Grove, Minnesota |
| Authorized Official Name and Position | Kristine Williams (CFO) |
| Authorized Official Contact | 7638983517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med Cell Regenerate, Llc 7373 Kirkwood Ct N Ste 110 Maple Grove MN 55369-5211 Ph: (763) 898-3517 | Med Cell Regenerate, Llc 7373 Kirkwood Ct N Ste 110 Maple Grove MN 55369-5211 Ph: (763) 898-3517 |
| NPI Number | 1356956163 |
|---|---|
| Provider Enumeration Date | 09/09/2020 |
| Last Update Date | 09/29/2021 |
| Medicare PECOS PAC ID | 3870900509 |
|---|---|
| Medicare Enrollment ID | O20210325000914 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356956163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Nicola Forcha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992477814 PECOS PAC ID: 7618366618 Enrollment ID: I20211112002487 |
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