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Organization

ALLINA HEALTH SYSTEM

Active
Other names
Allina Health Bandana Square Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DOMINICA TALLARICO (COO)
(612) 222-2222
Entity
Organization

Contact information

Practice address
1021 BANDANA BLVD E, STE 100, ST PAUL, MN 55108-5109
(651) 241-9700
Mailing address
PO BOX 43, MAIL ROUTE 10585, MINNEAPOLIS, MN 55440-0043
(612) 262-1166

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207QS1201X
Sleep Medicine (Family Medicine) Physician
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
01/27/2011
Last updated
01/14/2025
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