Organization
PARK NICOLLET HEALTH CARE PRODUCTS
Active
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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