# GILLETTE CHILDREN'S SPECIALTY HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1457747172
- **Legal business name:** GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
- **Authorized official:** JAMES L HADDICAN (VP OF FINANCE/CFO)
- **Authorized official phone:** (651) 312-3105

## Contact information

- **Practice address:** 323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
- **Practice address phone:** (651) 634-1938
- **Mailing address:** 200 UNIVERSITY AVE E, PATIENT ACCOUNTING DEPT 2ND FLOOR, 435 PHALEN, SAINT PAUL, MN 55101-2507
- **Mailing address phone:** (651) 325-2177
- **Mailing address fax:** (651) 325-2122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 04/09/2015
- **Last updated:** 04/09/2015