Provider Demographics
NPI:1851612154
Name:MEDSAVE FAMILY WELLNESS CENTER
Entity Type:Organization
Organization Name:MEDSAVE FAMILY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:CHERNUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-759-1222
Mailing Address - Street 1:217 PAUL BUNYAN DR NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-2433
Mailing Address - Country:US
Mailing Address - Phone:218-759-1222
Mailing Address - Fax:
Practice Address - Street 1:217 PAUL BUNYAN DR NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-2433
Practice Address - Country:US
Practice Address - Phone:218-759-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty