1861499873 NPI number — MCKESSON MEDICAL-SURGICAL MEDINET INC.

Table of content: (NPI 1861499873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861499873 NPI number — MCKESSON MEDICAL-SURGICAL MEDINET INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCKESSON MEDICAL-SURGICAL MEDINET 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:
1861499873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8121 10TH AVE N
Provider Second Line Business Mailing Address:
DEPARTMENT 312
Provider Business Mailing Address City Name:
GOLDEN VALLEY
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55427-4401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-328-8111
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10220 SW GREENBURG RD
Provider Second Line Business Practice Location Address:
2 LINCOLN CENTER, SUITE 410
Provider Business Practice Location Address City Name:
TIGARD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-5503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-722-0422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BLANCHFILL
Authorized Official First Name:
BILL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
VP/CHIEF COMPLIANCE OFFICER
Authorized Official Telephone Number:
763-595-6130

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: 00692293X , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: MS726MN , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0914630 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 158241 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 66875544 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54506401 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1850083 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1667498 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DME01751G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000687416 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00951070 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com