Organization
PEDIATRIC HOME RESPIRATORY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE FINCH (BILLING MANAGER)
(651) 642-1825
Entity
Organization
Contact information
Practice address
2800 CLEVELAND AVE N, ROSEVILLE, MN 55113-1126
(651) 642-1825
Mailing address
2800 CLEVELAND AVE N, ROSEVILLE, MN 55113-1126
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09439PE
BCBS MN
MN
01
—
1068680001
MEDICARE ID
MN
Enumeration date
06/02/2008
Last updated
12/05/2018
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