Healthcare Provider Details

I. General information

NPI: 1073883666
Provider Name (Legal Business Name): PARK POINT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7362 UNIVERSITY AVE NE STE 211
FRIDLEY MN
55432-3151
US

IV. Provider business mailing address

7362 UNIVERSITY AVE NE STE 211
FRIDLEY MN
55432-3151
US

V. Phone/Fax

Practice location:
  • Phone: 763-205-3891
  • Fax: 612-206-8284
Mailing address:
  • Phone: 763-205-3891
  • Fax: 612-206-8284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number263818
License Number StateMN

VIII. Authorized Official

Name: ELVIS E OSAGIE
Title or Position: PRESIDENT/CEO
Credential:
Phone: 347-693-8496