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1811999162

NPI Code Detail

MEDICARE: INDIAN HEALTH BOARD OF MINNEAPOLIS, INC

MEDICARE: INDIAN HEALTH BOARD OF MINNEAPOLIS, INC

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	261QF0400X	Federally Qualified Health Center (FQHC)	6115875	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811999162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIAN HEALTH BOARD OF MINNEAPOLIS, INC

Provider Business Mailing Address
First Line	:	1315 E 24TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3975
Country	:	US
Telephone Number	:	612-721-9800
Fax Number	:	612-721-7870

Provider Business Practice Location Address
First Line	:	1315 E 24TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-3975
Country	:	US
Telephone Number	:	612-721-9800
Fax Number	:	612-721-7870

Authorized Official
Title or Position	:	CEO
Name	:	DR. PATRICK ROCK
Credential	:	M.D.
Telephone Number	:	612-721-9881

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	01/19/2011

Similar Medicare Providers

1235134354 — DR. PATRICK MICHAEL ROCK M.D.
Practice Location Address:

1315 E 24TH ST
MINNEAPOLIS, MN
55404-3975

Practice Phone: 612-721-9856
Practice Fax: 612-721-2904

1336144179 — DR. MITCHELL J LACOMBE M.D.
Practice Location Address:

1315 E 24TH ST
MINNEAPOLIS, MN
55404-3975

Practice Phone: 612-721-9866
Practice Fax: 612-721-2904

1215933486 — HATTIE L. THORN-BLACK D.D.S.
Practice Location Address:

1315 E 24TH ST
MINNEAPOLIS, MN
55404-3975

Practice Phone: 612-721-9825
Practice Fax: 612-721-2904

1891792404 — MUNIR BATTIKHI D.D.S.
Practice Location Address:

1315 E 24TH ST
MINNEAPOLIS, MN
55404-3975

Practice Phone: 612-721-9800
Practice Fax: 612-721-2904

1457312225 — MICHAEL L. HARRIS M.A., L.P.
Practice Location Address:

1315 E 24TH ST
MINNEAPOLIS, MN
55404-3975

Practice Phone: 612-721-9868
Practice Fax: 612-721-9850

1366496200 — SHEILA C THORSTENSON D.D.S.
Practice Location Address:

1315 E 24TH ST
MINNEAPOLIS, MN
55404-3975

Practice Phone: 612-721-9800
Practice Fax: 612-721-2904

Directions to “INDIAN HEALTH BOARD OF MINNEAPOLIS, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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