Provider Demographics
NPI:1134313604
Name:THE CENTER CLINIC INC
Entity Type:Organization
Organization Name:THE CENTER CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VOLUNTEER MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-633-9200
Mailing Address - Street 1:104 1ST ST NW
Mailing Address - Street 2:PO 67
Mailing Address - City:DODGE CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55927-9195
Mailing Address - Country:US
Mailing Address - Phone:507-633-9200
Mailing Address - Fax:507-374-2555
Practice Address - Street 1:104 1ST ST NW
Practice Address - Street 2:PO 67
Practice Address - City:DODGE CENTER
Practice Address - State:MN
Practice Address - Zip Code:55927-9195
Practice Address - Country:US
Practice Address - Phone:507-633-9200
Practice Address - Fax:507-374-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility