Organization Name: | COLUMBIA PARK MEDICAL GROUP, PA |
NPI Number: | 1609976570 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOEN V CONDON (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 6341 University Ave Ne Fridley |
State: | MN US |
Postal Code: | 554324946 |
Phone Number: | 7635725710 |
Fax Number: | 7635865888 |
NPI Enumeration Date: | 09/22/2006 |
NPI Last Update Date: | 11/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |