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Organization

INDIAN HEALTH BOARD OF MINNEAPOLIS, INC

Active
Other names
Indian Health Board of Minneapolis, Inc
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICK ROCK M.D. (CEO)
(612) 721-9881
Entity
Organization

Contact information

Practice address
1315 E 24TH ST, MINNEAPOLIS, MN 55404-3975
(612) 721-9800
(612) 721-7870
Mailing address
1315 E 24TH ST, MINNEAPOLIS, MN 55404-3975
(612) 721-9800
(612) 721-7870

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
6115875
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125028100
MN
05
138488100
MN
05
206817600
MN
05
634930700
MN
05
730320300
MN
05
781137300
MN
05
844522200
MN
05
916817600
MN
05
934633300
MN
05
942317600
MN
05
946883800
MN
05
996488600
MN
Enumeration date
06/01/2005
Last updated
01/19/2011
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