1881054369 NPI number — TWIN CITY CHRISTIAN HOMES SERVICES COMPANY

Table of content: DR. PAMELA MIRIAM RUTSTEIN DPT (NPI 1013078849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881054369 NPI number — TWIN CITY CHRISTIAN HOMES SERVICES COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TWIN CITY CHRISTIAN HOMES SERVICES COMPANY
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:
6
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:
1881054369
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7645 LYNDALE AVE S STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHFIELD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55423-6008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-243-4585
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22027 420TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCGREGOR
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55760-5963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
218-768-3379
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/26/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ETHRIDGE
Authorized Official First Name:
DENYSE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF OPERATIONS
Authorized Official Telephone Number:
612-243-4585

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  372405 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com