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General NPI Number Information
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NPI Number | 1487773990
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Entity Type | Organization
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Legal Business Name | PARKER HUGHES CLINICS
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2665 LONG LAKE RD
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City | ROSEVILLE
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State | MN
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Zip | 55113-2538
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Country | US
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Telephone | 651-796-5400
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Fax | 651-796-5480
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Provider Business Mailing Address
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Address Line | 2665 LONG LAKE RD
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City | ROSEVILLE
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State | MN
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Zip | 55113-2538
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Country | US
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Telephone | 651-796-5400
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Fax | 651-796-5480
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Authorized Official
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Title or Position | SR. VICE PRESIDENT, FINANCE
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Name | MS. KATHRYN M. REALI
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Credential | CPA
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Telephone | 651-796-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | 261857
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License Number State | MN
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