Organization
LAC QUI PARLE CLINIC OF MADISON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL M BORGERSON (CFO)
(320) 698-7152
Entity
Organization
Contact information
Practice address
820 3RD AVE, MADISON, MN 56256-1014
(320) 598-7551
(320) 598-7553
Mailing address
900 2ND AVE, MADISON, MN 56256-1006
(320) 598-7551
(320) 598-7553
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106646
UCARE
MN
01
—
3F739LA
BCBS
MN
05
—
933813600
—
MN
Enumeration date
06/20/2006
Last updated
05/16/2024
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