1932251402 NPI number — PHARMACEUTICAL CARE ASSOCIATES, INC.

Table of content: JOHN PAUL GUIDARELLI MSPT (NPI 1508368903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932251402 NPI number — PHARMACEUTICAL CARE ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHARMACEUTICAL CARE ASSOCIATES, 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:
1932251402
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5003
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOPKINS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55343-1003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-384-3784
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5702 NEWPORT DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
EDINA
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55436-1726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-384-3784
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KRELITZ
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
612-384-3784

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  262492-1 , 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)





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