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Organization

PARK NICOLLET HEALTH CARE PRODUCTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN DENISE BREY (SUPERVISOR/DELEGATED OFFICIAL)
(952) 993-6832
Entity
Organization

Contact information

Practice address
4916 EXCELSIOR BLVD # MS 61901C, ST LOUIS PARK, MN 55416-3032
(952) 993-6832
(952) 993-0562
Mailing address
3800 PARK NICOLLET BLVD # MS 61901C, ST LOUIS PARK, MN 55416-2527
(952) 993-6832
(952) 993-0562

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6019472
MN

Other

Enumeration date
12/26/2017
Last updated
12/05/2024
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