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GILLETTE CHILDREN'S SPECIALTY HEALTHCARE

Suppliers Durable Medical Equipment & Medical Supplies

Provider NPI: 1477612604

Organization Information:
Organization Name:  GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Organization is Subpart
Authorized Official:  PATRICK  NOLAN  CFO  651-312-3105

Practice Location:
1420 LONDON RD  DULUTH, MN 55805-2433 US
Tel: 218-728-6160  Fax: 218-724-6982

Business Mailing Address:
200 UNIVERSITY AVE E  SAINT PAUL, MN 55101-2507 US
Tel: 651-291-2848  Fax: 651-325-2174

NPI Information:
NPI: 1477612604
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
MN
N332BC3200XSuppliers
Durable Medical Equipment & Medical Supplies
MN
N261QM1300XAmbulatory Health Care Facilities
Clinic/Center
Y335E00000XSuppliers
Prosthetic/Orthotic Supplier
MN

Other Provider Identifiers:

IssuerNumberStateType
235422100MN05
41683100WI05
103632000MN05
11003700WI05
BLUE CROSS BLUE SHIELD1111HGI01



American Medical Association 2012 taxonomy code information

Code: 335E00000X

Type:

Classification:



Definition:



MEDICAL JOBS MN - Page 1

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