Organization
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Active
Other names
Gillette Children's Specialty Healthcare Pharmacy, GILLETTE CHILDRENS SPECIALTY HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA HARTZLER (MANAGER PAYER RELATIONS AND STRATEG)
(651) 325-2209
Entity
Organization
Contact information
Practice address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 726-2890
(651) 726-2848
Mailing address
200 UNIVERSITY AVE E # 010614, SAINT PAUL, MN 55101-2507
(651) 325-2209
(651) 325-2221
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
262713
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025653700
—
NE
05
—
100440690B
—
KS
05
—
1386758373
—
MT
05
—
1678053F
—
IA
01
—
2049091
PK
—
05
—
21513
—
ND
05
—
33295600
—
WI
05
—
376978000
—
MN
05
—
8535290
—
SD
Enumeration date
08/18/2006
Last updated
09/14/2021
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