Organization
HEALTHEAST CARE SYSTEM
Active
Parent organization
HEALTHEAST CARE SYSTEM
Other names
HealthEast Home Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEALTHEAST CARE SYSTEM
Authorized official
DOUG DAVENPORT (CFO)
(651) 232-2250
Entity
Organization
Contact information
Practice address
1700 UNIVERSITY AVE W, 4TH FLOOR, SAINT PAUL, MN 55104-3727
(651) 232-2800
(651) 232-2898
Mailing address
1655 BEAM AVE, MAPLEWOOD, MN 55109-1163
(651) 232-2800
(651) 232-2898
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
331635
MN
332B00000X
Durable Medical Equipment & Medical Supplies
331635
MN
3336H0001X
Home Infusion Therapy Pharmacy
331635
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413993300 IV
—
MN
05
—
433673900
—
MN
Enumeration date
10/13/2009
Last updated
11/14/2019
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