Organization
PARK NICOLLET HEALTH CARE PRODUCTS
Active
Parent organization
PARK NICOLLET HEALTH SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK NICOLLET HEALTH SERVICES
Authorized official
CATHERINE F LENAGH (CFO)
(952) 993-3108
Entity
Organization
Contact information
Practice address
1885 PLAZA DR, EAGAN, MN 55122-2612
(952) 993-4001
Mailing address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3336C0002X
Clinic Pharmacy
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2415253
NCPDP PROVIDER INDENTIFICATION NUMBER
—
Enumeration date
11/06/2006
Last updated
10/02/2014
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