Organization
CHILDRENS HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA LU ALEXANDER MCCORMICK (SR. VP AND CHIEF FINANCIAL OFFICER)
(612) 813-6129
Entity
Organization
Contact information
Practice address
2525 CHICAGO AVE S, MINNEAPOLIS, MN 55404
(612) 813-6111
Mailing address
5901 LINCOLN DRIVE, CBC-2-REV/PE, EDINA, MN 55436-1611
(952) 992-5691
(952) 992-6917
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
331018
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435247500
—
MN
01
—
C02052
MEDICARE
MN
Enumeration date
09/21/2006
Last updated
10/31/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up