1699953000 NPI number — NORTH MEMORIAL HEALTH CARE

Table of content: (NPI 1699953000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699953000 NPI number — NORTH MEMORIAL HEALTH CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH MEMORIAL HEALTH CARE
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:
NORTH MEMORIAL HEALTH SPECIALTY CENTER - ROBBINSDALE
Provider Other Organization Name Type Code:
3
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:
1699953000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 735463
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60673-5463
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-520-5200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 OAKDALE AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROBBINSDALE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55422-2926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-520-5200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALBRIGHT
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
763-581-4768

Provider Taxonomy Codes

  • Taxonomy code: 261QM2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 111387 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1035HNO . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 5000812 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".