PARK NICOLLET HEALTH CARE PRODUCTS (NPI# 1548222953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548222953 |
| Entity Type | Organization |
| Organization Name | PARK NICOLLET HEALTH CARE PRODUCTS |
| Practice Address |
15800 95th Ave N Maple Grove MN 55369-4400 |
| Mailing Address |
3800 Park Nicollet Blvd St Louis Park MN 55416-2527 |
| Practice Telephone | 9529931440 |
| Mailing Telephone | 9529931000 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2014-10-02 |
| Authorized Official Name | CATHERINE F LENAGH (CFO) |
| Authorized Official Telephone | 9529933108 |
| Is Organization Subpart | Y |
| Parent Organization Name | PARK NICOLLET HEALTH SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
263381 | MN | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2429733 | 01 | |
| MN | 21398500 | 05 |
| 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 |
| 1114438546 | Park Nicollet Health Care Products | Durable Medical Equipment & Medical Supplies | 411 Stageline Rd, Hudson, WI 54016-7848 | 2017-10-12 |
| 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 |
| Street Address |
15800 95TH AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-4400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225011760 | Bernt J Helgaas | Internal Medicine | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2005-11-29 |
| 1174980692 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2016-01-28 |
| 1558707455 | Jaclyn C Hawes | Physician Assistant | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2013-05-17 |
| 1346561032 | Valerie Lee Saladin | Physician Assistant | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2010-06-16 |
| 1417198839 | Jeannette A Heidlberg | Internal Medicine | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2009-03-13 |
| 1205009016 | Alisa Brooke Grismer | Pharmacist | 15800 95th Ave N, Park Nicollet, Maple Grove, MN 55369-4400 | 2008-04-12 |
| 1619096245 | Jacob Jared Sundberg | Chiropractor | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2007-03-28 |
| 1982748349 | Sonya Schober | Internal Medicine | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2007-02-19 |
| 1104962844 | Christine Suzanne Goudge Walker | Obstetrics & Gynecology | 15800 95th Ave N, Park Nicollet - Dept of Ob/gyn, Maple Grove, MN 55369-4400 | 2007-01-29 |
| 1750469219 | Jerusha Clare Brager | Physical Therapist | 15800 95th Ave N, Rehab, Maple Grove, MN 55369-4400 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| 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 |
|---|---|---|---|---|
| 1740799055 | Lifehouse Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 7437 Narcissus Ln N, Maple Grove, MN 55311-1726 | 2017-09-29 |
| 1043729452 | Yamaco Home Health Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 8903 Pineview Ln N, Maple Grove, MN 55369-6557 | 2017-09-28 |
| 1780814467 | Oakdale Health Enterprises, Inc. | Durable Medical Equipment & Medical Supplies | 13800 83rd Way N Ste 102b, Maple Grove, MN 55369-7016 | 2009-07-16 |
| 1619145943 | Liberty Oxygen and Home Care, Inc | Durable Medical Equipment & Medical Supplies | 16322 County Road 30, Maple Grove, MN 55311-1207 | 2008-02-20 |
| 1730363698 | Gillette Children's Specialty Healthcare | Durable Medical Equipment & Medical Supplies | 9550 Upland Lane North, Suite 220, Maple Grove, MN 55369 | 2007-12-27 |
| 1780721886 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 16750 County Road 30, Maple Grove, MN 55311-4523 | 2007-01-30 |
| 1225109093 | Twin Cities Medical Supply | Durable Medical Equipment & Medical Supplies | 16720 73rd Pl N, Maple Grove, MN 55311-2130 | 2006-11-13 |
| 1679688717 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 8150 Wedgewood Ln N, Maple Grove, MN 55369 | 2006-08-20 |
| 1124033436 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 13611 Grove Dr, Maple Grove, MN 55311-4405 | 2006-07-29 |
| 1184641581 | Sams West Inc | Durable Medical Equipment & Medical Supplies | 16701 94th Ave N, Maple Grove, MN 55311-5448 | 2006-07-16 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
Please comment or provide details below to improve the information on PARK NICOLLET HEALTH CARE PRODUCTS.
| 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.