1699201541 NPI number — MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH

Table of content: (NPI 1699201541)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699201541 NPI number — MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH
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:
1699201541
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 083268
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:
60691-0268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-284-8451
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
32021 COUNTY 24 BLVD
Provider Second Line Business Practice Location Address:
SUITE 1716
Provider Business Practice Location Address City Name:
CANNON FALLS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55009-5003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-263-9825
Provider Business Practice Location Address Fax Number:
507-263-9657
Provider Enumeration Date:
05/11/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SWANSON
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
507-538-1680

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0297530014 . This is a "MEDICARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 24-33542 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 265329 . This is a "MN LICENSE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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