Organization
CROWN MEDICAL SUPPORT SERVICES INC
Active
Parent organization
1730546672
Other names
Crown Medical 245G Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
1730546672
Authorized official
DR. CHIKE ORIZU ONYEKABA (PROGRAMS COORDINATOR)
(612) 871-4354
Entity
Organization
Contact information
Practice address
1925 1ST AVE S, MINNEAPOLIS, MN 55403-3724
(612) 978-3783
(612) 354-7719
Mailing address
1925 1ST AVE S, MINNEAPOLIS, MN 55403-3724
(612) 978-3783
(612) 354-7719
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
02/26/2024
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