MEDICARE: MINNESOTA LAWN CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305S00000X	Point of Service

General Provider Information

NPI Number	:	1619762184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINNESOTA LAWN CARE

Provider Business Mailing Address
First Line	:	9210 WYOMING AVE N STE 260
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-1865
Country	:	US
Telephone Number	:	763-425-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9210 WYOMING AVE N STE 260
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-1865
Country	:	US
Telephone Number	:	763-425-1200
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	GARY OLSEN
Credential	:
Telephone Number	:	763-691-3443

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	04/14/2025

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Directions to “MINNESOTA LAWN CARE ” Practice Location

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