MEDICARE: HEALTHEAST MEDICAL RESEARCH INSTITUTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1003577420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHEAST MEDICAL RESEARCH INSTITUTE

Provider Business Mailing Address
First Line	:	1700 UNIVERSITY AVE W
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-3727
Country	:	US
Telephone Number	:	612-672-6740
Fax Number	:	612-884-3592

Provider Business Practice Location Address
First Line	:	1747 BEAM AVE STE 100
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55109-1128
Country	:	US
Telephone Number	:	651-326-5569
Fax Number	:

Authorized Official
Title or Position	:	SYS DIR GOVT REIMB & NETWK REL
Name	:	MAUREEN V RING
Credential	:
Telephone Number	:	612-672-6740

Provider Enumeration Date	:	01/07/2022
Last Update Date	:	02/14/2025

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