Pediatric And Young Adult Medicine, Pa

LBN: Pediatric And Young Adult Medicine, Pa
Pediatric And Young Adult Medicine, Pa is an health care organization with primary practice located at 8650 Hudson Blvd N Suite 125, Lake Elmo MN 55042-9747. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Pediatric And Young Adult Medicine, Pa can be contacted via phone (651) 256-6706, or through Joseph, Terri M via phone (651) 256-6706.

Contact Information

Primary practice address
8650 Hudson Blvd N Suite 125 Lake Elmo MN 55042-9747
Phone: (651) 256-6706
Fax: (651) 256-6707
Website:
Map and Directions
Authorized official contact:
Name: Joseph, Terri M
Phone: (651) 256-6706

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 154 Minnesota

Profile Details

NPI number 1457593550
LBN Legal business name Pediatric And Young Adult Medicine, Pa
DBA Doing business as
Authorized official Joseph, Terri M
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2009
Last updated Dec 7th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457593550 NPPES
Minnesota MEDICAID 1104806165
Minnesota MEDICAID 1245210095
Minnesota MEDICAID 1245210210
Minnesota MEDICAID 1861558835
Minnesota MEDICAID 1083694046
Minnesota MEDICAID 1477870921
Minnesota MEDICAID 1386991339
Minnesota MEDICAID 1881057065
Minnesota MEDICAID 1912987900
Minnesota MEDICAID 1497735419

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