Organization
PARK NICOLLET METHODIST HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JAMES LUHRS (VP FINANCE)
(952) 883-7158
Entity
Organization
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426
(952) 993-5000
(952) 993-1980
Mailing address
PO BOX 1488, MINNEAPOLIS, MN 55480-1488
(952) 993-1990
(952) 993-1980
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
331010
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11004800
MEDICAID
WI
05
—
407345200
—
MN
Enumeration date
05/11/2006
Last updated
10/25/2021
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