Park Nicollet Health Care Products

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

6019472 Issued in MN

Legal business name

PARK NICOLLET HEALTH CARE PRODUCTS

Practice address

535 Hospital Rd
New Richmond, WI 54017-1449

Phone

(715) 243-3400

NPI assigned

Sep 13, 2017

Organization subpart

Yes

Parent organization

PARK NICOLLETAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Catherine F Lenagh, AUTHORIZED OFFICIAL

Title

VP, Cfo, Ceo

Phone

(952) 993-3108

Specialties & licenses 1

Addresses

Part of

Park Nicollet

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1629597331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD 6WS01C",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-993-6832",
            "fax_number": "952-993-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 HOSPITAL RD",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171449",
            "telephone_number": "715-243-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NICOLLET HEALTH CARE PRODUCTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK NICOLLET",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "LENAGH",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VP, CFO, CEO",
        "authorized_official_telephone_number": "952-993-3108",
        "authorized_official_credential": "AUTHORIZED OFFICIAL"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "6019472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis W. Olson, CRNA
• David L Olson, MD
• Onward Pediatric Therapy, LLC
• Julie Ann Paleen Aronow, MFT
• Melissa Pankonin, PHARMD.
• Madelyn Sara Pearson, D.D.S.
• Anna Pedersen, DPT
• Philippine Dana Dawn Peralta, MD
• Todd Dennis Petersen, CRNA
• Jennifer Peterson

• Durable Medical Equipment & Medical Supplies in New Richmond, WI
• Providers in New Richmond, WI by specialty
• Durable Medical Equipment & Medical Supplies in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.