Organization
CHILDRENS HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA LU ALEXANDER MCCORMICK (SR. VP AND CHIEF FINANCIAL OFFICER)
(612) 813-6129
Entity
Organization
Contact information
Practice address
2525 CHICAGO AVE S, MINNEAPOLIS, MN 55404
(612) 813-6280
(612) 813-6951
Mailing address
5901 LINCOLN DRIVE, CBC-2-REV/PE, EDINA, MN 55436-1611
(952) 992-5691
(952) 992-6917
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435247500
—
MN
Enumeration date
09/21/2006
Last updated
10/31/2022
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