Healthcare Provider Details

I. General information

NPI: 1295182855
Provider Name (Legal Business Name): ALLINA HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 SMITH AVE N STE 200
SAINT PAUL MN
55102-2697
US

IV. Provider business mailing address

2925 CHICAGO AVE MR 10585
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-5111
  • Fax: 651-241-5512
Mailing address:
  • Phone: 612-262-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DOMINICA TALLARICO
Title or Position: COO
Credential:
Phone: 612-222-2222