PARK NICOLLET HEALTH CARE PRODUCTS (NPI# 1114438546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114438546 |
| Entity Type | Organization |
| Organization Name | PARK NICOLLET HEALTH CARE PRODUCTS |
| Practice Address |
411 Stageline Rd Hudson WI 54016-7848 |
| Mailing Address |
3800 Park Nicollet Blvd 6ws01c St Louis Park MN 55416 |
| Practice Telephone | 7155316400 |
| Practice Fax Number | 9529930562 |
| Mailing Telephone | 9529936832 |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2017-10-12 |
| Authorized Official Name | KRISTIN DENISE BREY (SUPERVISER) |
| Authorized Official Telephone | 9529936832 |
| Authorized Official Credential | DELEGATED OFFICI |
| Is Organization Subpart | Y |
| Parent Organization Name | PARK NICOLLET |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 6019472 | MN | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376048728 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 921 Greeley St S # 19101a, Stillwater, MN 55082-5935 | 2018-03-28 |
| 1780103408 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 400 Wabasha Street Suite 260, St. Paul, MN 55102-1109 | 2017-09-13 |
| 1346598810 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 13688 Rogers Drive, Rogers, MN 55374-4916 | 2012-08-15 |
| 1235695594 | Park Nicollet Health Care Products | Eyewear Supplier (Equipment, not the service) | 8401 Golden Valley Rd, Golden Valley, MN 55427-4486 | 2019-02-12 |
| 1003311457 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 1500 Curve Crest Blvd W, Stillwater, MN 55082-6040 | 2018-03-28 |
| 1487159836 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 927 Churchill St W, Stillwater, MN 55082-6605 | 2018-03-28 |
| 1881100089 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 700 5th St S, Hopkins, MN 55343-7764 | 2017-12-26 |
| 1144749862 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 155 Radio Drive, Woodbury, MN 55125-2040 | 2017-09-13 |
| 1629597331 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 535 Hospital Rd, New Richmond, WI 54017-1449 | 2017-09-13 |
| 1316466188 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 640 Jackson St, Saint Paul, MN 55101-2502 | 2017-09-13 |
| Street Address |
411 STAGELINE RD |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-7848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568840916 | Infinite Health Collaborative, Pa | Durable Medical Equipment & Medical Supplies | 411 Stageline Rd, Suite 100, Hudson, WI 54016-7848 | 2015-05-18 |
| 1699308593 | Kimberly Lou Webb | Physical Therapist | 411 Stageline Rd, Hudson, WI 54016-7848 | 2020-02-19 |
| 1902439243 | Jessica Stoner | Physical Therapist | 411 Stageline Rd, Hudson, WI 54016-7848 | 2020-02-14 |
| 1457984791 | Abigail Rolinger | Physical Therapist | 411 Stageline Rd, Hudson, WI 54016-7848 | 2020-02-14 |
| 1881232148 | Brenda Kristy Eckerman | Physical Therapist | 411 Stageline Rd, Hudson, WI 54016-7848 | 2019-12-18 |
| 1932766441 | Kari Nicole Medearis | Audiologist | 411 Stageline Rd, Hudson, WI 54016-7848 | 2019-05-21 |
| 1285188037 | Janelle A Niebeling | Occupational Therapist | 411 Stageline Rd, Hudson, WI 54016-7848 | 2016-08-10 |
| 1548622863 | Dan Krakora | Dermatology | 411 Stageline Rd, Hudson, WI 54016-7848 | 2016-03-25 |
| 1427420181 | Group Health Plan Inc | Clinic/Center | 411 Stageline Rd, #200, Hudson, WI 54016 | 2015-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356807929 | Amerita, Inc. | Durable Medical Equipment & Medical Supplies | 577 Main St Ste 360, Hudson, MA 01749-3046 | 2019-02-19 |
| 1033618830 | Thomas Ruff | Durable Medical Equipment & Medical Supplies | 12121 Little Rd # 270, Hudson, FL 34667-2924 | 2018-02-07 |
| 1568840916 | Infinite Health Collaborative, Pa | Durable Medical Equipment & Medical Supplies | 411 Stageline Rd, Suite 100, Hudson, WI 54016-7848 | 2015-05-18 |
| 1245598283 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 141 Carmichael Rd, Hudson, WI 54016-7716 | 2012-04-27 |
| 1598031346 | Martins Foods of South Burlington LLC | Durable Medical Equipment & Medical Supplies | 32 Route 82, Hudson, NY 12534-4449 | 2012-03-27 |
| 1134410723 | Great Lakes Medical Solutions, Inc. | Durable Medical Equipment & Medical Supplies | 1521 Georgetown Rd Ste 205, Hudson, OH 44236-4093 | 2011-04-29 |
| 1891094439 | Jems Healthcare Inc | Durable Medical Equipment & Medical Supplies | 112 Legion Rd, Hudson, NC 28638-2220 | 2011-03-22 |
| 1497051270 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 14851 State Road 52, Hudson, FL 34669-4061 | 2011-01-27 |
| 1356573182 | Parkwood Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 9706 State Road 52, Hudson, FL 34669-3003 | 2009-08-12 |
| 1750511333 | Timothy Scott Saxon | Durable Medical Equipment & Medical Supplies | 13221 Golf Ridge Pl, Hudson, FL 34669-2461 | 2009-07-17 |
| Find all providers in HUDSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.