Organization
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Active
Parent organization
GILLETTE CHILDREN'S SPECIALITY HEALTHCARE
Other names
Gillette Children's Healthcare-Burnsville
Organization subpart
Yes
Provider details
NPI number
Legal business name
GILLETTE CHILDREN'S SPECIALITY HEALTHCARE
Authorized official
PATRICK NOLAN (CFO)
(651) 312-3105
Entity
Organization
Contact information
Practice address
305 E NICOLLET BLVD, SUITE 200, BURNSVILLE, MN 55337-8327
(952) 223-3400
(952) 223-3405
Mailing address
200 UNIVERSITY AVE E, SAINT PAUL, MN 55101-2507
(651) 291-2848
(651) 325-2174
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
MN
332BC3200X
Customized Equipment (DME)
—
MN
335E00000X
Prosthetic/Orthotic Supplier
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11003700
—
WI
01
—
1111HGI
BLUE CROSS BLUE SHIELD
—
05
—
366138000
—
MN
05
—
41683100
—
WI
05
—
578182000
—
MN
Enumeration date
12/06/2006
Last updated
12/13/2019
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