Healthcare Provider Details

I. General information

NPI: 1285657247
Provider Name (Legal Business Name): NORTH MEMORIAL HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

IV. Provider business mailing address

PO BOX 735463
CHICAGO IL
60673-5463
US

V. Phone/Fax

Practice location:
  • Phone: 763-581-3440
  • Fax: 763-581-3441
Mailing address:
  • Phone: 763-581-3440
  • Fax: 763-581-3441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE R GALE
Title or Position: INTERIM CFO
Credential:
Phone: 763-581-4635