GILLETTE CHILDRENS SPECIALTY HEALTHCARE NPI 1760541700

NPI Information

NPI: 1760541700
Provider Name: GILLETTE CHILDRENS SPECIALTY HEALTHCARE
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
435 PHALEN BLVD
SAINT PAUL, MN
ZIP 55130
Phone: (651) 636-9443
Get Directions

GILLETTE CHILDRENS SPECIALTY HEALTHCARE is a customized equipment durable medical equipment medical supplies in Saint Paul, MN. GILLETTE CHILDRENS SPECIALTY HEALTHCARE NPI is 1760541700. The provider is registered as an organization entity type.

The provider's business location address is:

435 PHALEN BLVD
SAINT PAUL, MN
ZIP 55130-302
Phone: (651) 636-9443

The provider's authorized official is Patrick Nolan .
The authorized official title is Cfo and has the following contact phone number (651) 312-3105.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 12/13/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty		No
2	332B00000X	Durable Medical Equipment & Medical Supplies		MINNESOTA	No
3	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	MINNESOTA	Yes
4	335E00000X	Prosthetic/Orthotic Supplier		MINNESOTA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	310980000	MEDICAID	MINNESOTA
2	5521290	MEDICAID	SOUTH DAKOTA
3	9163630	MEDICAID	SOUTH DAKOTA
4	01267	MEDICAID	NORTH DAKOTA
5	0700813	MEDICAID	IOWA
6	498935487	MEDICAID	MICHIGAN
7	51199	MEDICAID	NORTH DAKOTA
8	0520726	MEDICAID	IOWA
9	41683100	MEDICAID	WISCONSIN
10	996047300	MEDICAID	MINNESOTA
11	465410000	MEDICAID	MINNESOTA
12	11003700	MEDICAID	WISCONSIN
13	1111HGI	OTHER		BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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