Healthcare Provider Details

I. General information

NPI: 1962914333
Provider Name (Legal Business Name): HENNEPIN HEALTHCARE SYSTEM, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S 8TH ST SL10
MINNEAPOLIS MN
55404-1284
US

IV. Provider business mailing address

701 PARK AVENUE P1 - FINANCE
MINNEAPOLIS MN
55415-1829
US

V. Phone/Fax

Practice location:
  • Phone: 612-617-4600
  • Fax:
Mailing address:
  • Phone: 612-873-3513
  • Fax:

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 Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LISA ANDERSON
Title or Position: CFO
Credential:
Phone: 612-873-9505