Healthcare Provider Details

I. General information

NPI: 1417548959
Provider Name (Legal Business Name): ALLINA HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 CATLIN ST STE 1000
BUFFALO MN
55313-1947
US

IV. Provider business mailing address

PO BOX 43 MAIL ROUTE 10585
MINNEAPOLIS MN
55440-0043
US

V. Phone/Fax

Practice location:
  • Phone: 763-682-1212
  • Fax:
Mailing address:
  • Phone: 612-262-1166
  • Fax: 612-262-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA SHEPHERD
Title or Position: HOSPITAL PRESIDENT
Credential:
Phone: 763-688-7804