Organization
MINNESOTA ONCOLOGY HEMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL THOMPSON (CEO)
(651) 602-5365
Entity
Organization
Contact information
Practice address
3960 COON RAPIDS BLVD NW, # 311, COON RAPIDS, MN 55433-2569
(763) 236-9090
Mailing address
3960 COON RAPIDS BLVD NW, # 311, COON RAPIDS, MN 55433-2569
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
—
—
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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