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General NPI Number Information
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NPI Number | 1962447995
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Entity Type | Organization
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Legal Business Name | ALLINA HEALTH SYSTEM
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 255 SMITH AVE N STE 100
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City | ST PAUL
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State | MN
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Zip | 55102-2518
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Country | US
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Telephone | 651-241-7246
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 43 MAIL ROUTE 10585
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City | MINNEAPOLIS
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State | MN
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Zip | 55440-0043
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Country | US
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Telephone | 612-262-1166
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Fax |
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Authorized Official
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Title or Position | COO
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Name | DOMINICA TALLARICO
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Credential |
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Telephone | 612-222-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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