NPIMap

Organization Active NPI

Healtheast Care System

Doing business as HealthEast - Maplewood

  • Non-Pharmacy Dispensing Site
  • Maplewood, MN
National Provider Identifier
1982842290
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
40379 Issued in MN
Legal business name
HEALTHEAST CARE SYSTEM
Doing business as
HealthEast - Maplewood
Practice address
3100 Kennard St
100
Maplewood, MN 55109-4569
Phone
(651) 232-7800
NPI assigned
Jan 23, 2009
Last updated
Oct 22, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Kenny Heine
Title
Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 40379 MN Primary

Addresses

Primary practice location

3100 Kennard St
100
Maplewood, MN 55109-4569

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • HealthEast - Maplewood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Healtheast Gallery Int6 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1982842290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 KENNARD ST",
            "address_2": "100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551094569",
            "telephone_number": "651-232-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHEAST CARE SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2009-01-23",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MN",
            "license": "40379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthEast - Maplewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.