Park Nicollet Health Care Products

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PARK NICOLLET HEALTH CARE PRODUCTS

Practice address

4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119

Phone

(952) 993-7750

NPI assigned

Sep 24, 2009

Organization subpart

Yes

Parent organization

PARK NICOLLET HEALTH SERVICESAs 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

Title

Cfo

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": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1699009506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 PARK NICOLLET AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553724119",
            "telephone_number": "952-993-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK NICOLLET HEALTH CARE PRODUCTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK NICOLLET HEALTH SERVICES",
        "enumeration_date": "2009-09-24",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "LENAGH",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "952-993-3108"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Prior Lake, MN
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.