Organization
PARK NICOLLET HEALTH CARE PRODUCTS
Active
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
KRISTIN D BREY (SUPERVISOR/DELEGATED OFFICIAL)
(952) 993-6832
Entity
Organization
Contact information
Practice address
155 RADIO DRIVE, WOODBURY, MN 55125-2040
(952) 831-8742
(952) 993-0562
Mailing address
3800 PARK NICOLLET BLVD # MS 61901C, ST LOUIS PARK, MN 55416-2527
(952) 993-0562
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6019472
MN
Other
Enumeration date
09/13/2017
Last updated
11/07/2024
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