1427131424 NPI number — TACTILE SYSTEMS TECHNOLOGY, INC

Table of content: (NPI 1427131424)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427131424 NPI number — TACTILE SYSTEMS TECHNOLOGY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TACTILE SYSTEMS TECHNOLOGY, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427131424
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3701 WAYZATA BLVD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55416-3791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-355-5100
Provider Business Mailing Address Fax Number:
612-355-5101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3701 WAYZATA BLVD STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55416-3791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-355-5100
Provider Business Practice Location Address Fax Number:
612-355-5101
Provider Enumeration Date:
10/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BIRKEMEYER
Authorized Official First Name:
ELAINE
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
612-451-4149

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 103471500 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6682613 . This is a "CIGNA PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 611323800 . This is a "ACS PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 135J9TA . This is a "BCBS MN PROVIDER NUMBER" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".