# MINIMED DISTRIBUTION CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356334577
- **Authorized official:** QUE DALLARA (PRESIDENT)
- **Authorized official phone:** (800) 646-4633

## Contact information

- **Practice address:** 18000 DEVONSHIRE ST, ATTN: LEGAL DEPT., NORTHRIDGE, CA 91325-1219
- **Practice address phone:** (800) 933-3322
- **Practice address fax:** (818) 576-6228
- **Mailing address:** 18000 DEVONSHIRE ST, ATTN: MANAGED MARKETS, NORTHRIDGE, CA 91325-1219
- **Mailing address phone:** (800) 646-4633
- **Mailing address fax:** (818) 739-4843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 101284 | CA | Yes |

## Other

- **Enumeration date:** 08/23/2005
- **Last updated:** 03/27/2023