Organization
MINIMED DISTRIBUTION CORP.
Active
Parent organization
MEDTRONIC MINIMED
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDTRONIC MINIMED
Authorized official
JESSICA PUATHASNANON (CHIEF COUNSEL)
(804) 550-2017
Entity
Organization
Contact information
Practice address
1800 PYRAMID PL, MEMPHIS, TN 38132-1703
(800) 646-4633
(818) 739-4414
Mailing address
18000 DEVONSHIRE ST, ATTN: ANGELA WARD - LEGAL DEPT, NORTHRIDGE, CA 91325-1219
(800) 933-3322
(818) 576-6228
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137682716
—
AR
05
—
1454129
—
TN
Enumeration date
09/06/2007
Last updated
01/09/2018
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