Provider Demographics
NPI:1821755448
Name:THE PEOPLE'S HEALTH CARE LLC
Entity Type:Organization
Organization Name:THE PEOPLE'S HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANFOUO
Authorized Official - Middle Name:
Authorized Official - Last Name:MADAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-267-3097
Mailing Address - Street 1:7649 PALMGREN AVE NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-2688
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7649 PALMGREN AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-2688
Practice Address - Country:US
Practice Address - Phone:763-267-3097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center