Organization
PARK NICOLLET HEALTH CARE PRODUCTS
Active
Parent organization
PARK NICOLLET HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK NICOLLET HEALTH SERVICES
Authorized official
CATHERINE F LENAGH (CFO)
(952) 993-3108
Entity
Organization
Contact information
Practice address
15111 TWELVE OAKS CENTER DR, MINNETONKA, MN 55305-5201
(952) 993-4500
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-1000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332H00000X
Eyewear Supplier
—
—
3336C0002X
Clinic Pharmacy
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21398500
—
MN
01
—
2419643
NCPDP PROVIDER INDENTIFICATION NUMBER
—
Enumeration date
04/03/2006
Last updated
02/20/2025
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