Organization
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Active
Parent organization
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Authorized official
JAMES L HADDICAN (VP OF FINANCE/CFO)
(651) 312-3105
Entity
Organization
Contact information
Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(651) 634-1938
Mailing address
200 UNIVERSITY AVE E, PATIENT ACCOUNTING DEPT 2ND FLOOR, 435 PHALEN, SAINT PAUL, MN 55101-2507
(651) 325-2177
(651) 325-2122
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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