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NPI Code Detail

MEDICARE: WEST CENTRAL PATHOLOGY AND LABORATORY MEDICINE PA

MEDICARE: WEST CENTRAL PATHOLOGY AND LABORATORY MEDICINE PA
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
1291U00000XClinical Medical LaboratoryMN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4DA8276OTHERMNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11619967890OTHERMNNPI ENUMERATOR
2D197OTHERMNUCARE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
51134119324OTHERMNNPI ENUMERATOR

General Provider Information

NPI Number : 1811988025
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST CENTRAL PATHOLOGY AND LABORATORY MEDICINE PA
Provider Business Mailing Address
First Line : 2800 CAMPUS DR
Second Line : SUITE 150
City : PLYMOUTH
State : MN
Zip : 55441-2606
Country : US
Telephone Number : 763-201-0492
Fax Number :
Provider Business Practice Location Address
First Line : 111 17TH AVE E
Second Line :
City : ALEXANDRIA
State : MN
Zip : 56308-3703
Country : US
Telephone Number : 320-762-6068
Fax Number : 320-762-6145
Authorized Official
Title or Position : PATHOLOGIST
Name : DR. MARK REID SPANBAUER
Credential : MD
Telephone Number : 320-762-6068
Provider Enumeration Date : 11/04/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

1164424305 — DOUGLAS COUNTY HOSPITAL
Practice Location Address:
111 17TH AVE E
ALEXANDRIA, MN
56308-3703
Practice Phone: 320-762-1511
Practice Fax: 320-762-6101
1891795241 — SCOTT A SWENSON M.D.
Practice Location Address:
111 17TH AVE E
ALEXANDRIA, MN
56308-3703
Practice Phone: 320-762-6040
Practice Fax: 320-762-6038
1144221698 — RICHARD D EISER M.D.
Practice Location Address:
111 17TH AVE E
ALEXANDRIA, MN
56308-3703
Practice Phone: 320-762-6040
Practice Fax: 320-762-6038
1407840663 — MRS. MEAGAN JO CHRISTENSON ATC
Practice Location Address:
111 17TH AVE E
ALEXANDRIA, MN
56308-3703
Practice Phone: 320-762-6079
Practice Fax:
1619967890 — DR. MARK REID SPANBAUER M.D.
Practice Location Address:
111 17TH AVE E
ALEXANDRIA, MN
56308-3703
Practice Phone: 320-762-6072
Practice Fax: 320-762-6145
1134119324 — DR. DEAN QUANG TRINH MD
Practice Location Address:
111 17TH AVE E
ALEXANDRIA, MN
56308-3703
Practice Phone: 320-762-6073
Practice Fax: 320-762-6145

Directions to “WEST CENTRAL PATHOLOGY AND LABORATORY MEDICINE PA ” Practice Location

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