PARK NICOLLET METHODIST HOSPITAL (NPI# 1689112898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689112898 |
| Entity Type | Organization |
| Organization Name | PARK NICOLLET METHODIST HOSPITAL |
| Other Organization Name | PARK NICOLLET HOME INFUSION |
| Practice Address |
6500 Excelsior Blvd St Louis Park MN 55426-4702 |
| Practice Telephone | 9529935670 |
| Practice Fax Number | 9529935354 |
| Mailing Telephone | 9529935670 |
| Mailing Fax Number | 9529935354 |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-09 |
| Authorized Official Name | MR. DAVID BUSCH (VP PHARMACY OPERATIONS) |
| Authorized Official Telephone | 9529675049 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
200304 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100061250 | 05 |
| Other Name | Type Code |
|---|---|
| Park Nicollet Home Infusion | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649827973 | Park Nicollet Methodist Hospital | Clinic/Center | 14050 Fairview Dr, Burnsville, MN 55337-5713 | 2019-08-21 |
| 1174980692 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 15800 95th Ave N, Maple Grove, MN 55369-4400 | 2016-01-28 |
| 1245615772 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2015-07-27 |
| 1194113217 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 3900 Park Nicollet Blvd, St Louis Park, MN 55416-2503 | 2014-12-23 |
| 1942585286 | Park Nicollet Methodist Hospital | General Acute Care Hospital | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2011-10-19 |
| 1578717336 | Park Nicollet Methodist Hospital | Community Based Residential Treatment Facility, Mental Illness | 3525 Monterey Dr, St Louis Park, MN 55416-5275 | 2008-11-06 |
| 1942424742 | Park Nicollet Methodist Hospital | Pharmacy | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2007-04-12 |
| 1255478798 | Park Nicollet Methodist Hospital | Durable Medical Equipment & Medical Supplies | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2007-02-01 |
| 1083622047 | Park Nicollet Methodist Hospital | Anesthesiology | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2006-08-04 |
| 1447201421 | Park Nicollet Methodist Hospital | Home Health | 6500 Excelsior Blvd, St Louis Park, MN 55426 | 2006-05-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PARK NICOLLET METHODIST HOSPITAL | 6500 Excelsior Blvd, Saint Louis Park, MN 55426-4702 |
| Street Address |
6500 EXCELSIOR BLVD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-4702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861484669 | Robert E Haselow | Radiology | 6500 Excelsior Blvd, Methodist Radiation Therapy, St Louis Park, MN 55426-4702 | 2005-08-17 |
| 1215549381 | Katelyn Boys | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-08-20 |
| 1386253466 | Christine Harlander | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-24 |
| 1063021210 | Ian-thomas Campbell-groen | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2020-07-23 |
| 1619585387 | Kelly Faber | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-07-20 |
| 1952938821 | Paige Rygg | Physical Therapist | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-03-23 |
| 1801427406 | Brandi Jo St. Mane | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-02-01 |
| 1811528680 | Brian Servey IIi | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2020-01-30 |
| 1245873421 | Weston Poucher | Nurse Anesthetist, Certified Registered | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-10-21 |
| 1427609973 | Lauren Damrow | Registered Nurse | 6500 Excelsior Blvd, St Louis Park, MN 55426-4700 | 2019-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942424742 | Park Nicollet Methodist Hospital | Pharmacy | 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912060146 | Biorx LLC | Pharmacy | 8690 Eagle Creek Pkwy, Savage, MN 55378-1284 | 2006-12-19 |
| 1821048950 | Accredo Health Group Inc | Pharmacy | 2915 Waters Rd, Ste 109, Eagan, MN 55121-1562 | 2006-05-11 |
| 1942663711 | Healtheast Care System | Pharmacy | 1700 University Ave W, Saint Paul, MN 55104 | 2016-03-30 |
| 1548595218 | Healtheast Care System | Pharmacy | 1700 University Ave W, 4th Floor, Saint Paul, MN 55104-3727 | 2009-10-13 |
| 1962537118 | Fairview Pharmacy Services, LLC | Pharmacy | 711b Kasota Ave Se, Minneapolis, MN 55414 | 2007-02-21 |
| 1841332764 | Children's Health Care | Pharmacy | 2525 Chicago Avenue South, Minneapolis, MN 55404-4518 | 2007-02-14 |
| 1932266632 | Pediatric Home Respiratory Services LLC | Pharmacy | 2800 Cleveland Ave N, Roseville, MN 55113-1126 | 2007-01-02 |
| 1336180116 | Merwin Iv & Specialty Pharmacy, LLC | Pharmacy | 1811 Old Highway 8 Nw, Ste C, New Brighton, MN 55112-1828 | 2006-06-10 |
| City | ST LOUIS PARK |
| Zip Code | 55426 |
Please comment or provide details below to improve the information on PARK NICOLLET METHODIST HOSPITAL.
| 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.