HENDRICKS CLINIC PA NPI 1104850510

NPI Information

  • NPI: 1104850510
  • Provider Name: HENDRICKS CLINIC PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 24D0405219
  • Address: 501 E LINCOLN ST
    HENDRICKS, MN
    ZIP 56136
  • Phone: (507) 275-3121

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NPI Details

HENDRICKS CLINIC PA is a family medicine in Hendricks, MN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HENDRICKS CLINIC PA NPI is 1104850510. The provider is registered as an organization entity type.

The provider's business location address is:

501 E LINCOLN ST
HENDRICKS, MN
ZIP 56136-026
Phone: (507) 275-3121
Fax: (507) 275-3194

The provider's authorized official is Tabb L Mccluskey .
The authorized official title is Owner President and has the following contact phone number (507) 275-3121.

The CLIA number assigned to this NPI record is 24D0405219 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/10/2006 and was last updated on 12/28/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR1300XClinic/CenterRural Health1757969MINNESOTANo
2207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1232816000MEDICAIDMINNESOTA
2243826MEDICARE OSCAR/CERTIFICATION
3C07204MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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