=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982839791
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN LUNG ASSOCIATION OF THE UPPER MIDWEST
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2009
-----------------------------------------------------
Last Update Date | 05/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 490 CONCORDIA AVE
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55103-2412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-227-8014
-----------------------------------------------------
Fax | 651-227-5459
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 490 CONCORDIA AVE
-----------------------------------------------------
City | SAINT PAUL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55103-2412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 651-227-8014
-----------------------------------------------------
Fax | 651-227-5459
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER, RESPIRATORY HEALTH
-----------------------------------------------------
Name | HEATHER STEFFENS
-----------------------------------------------------
Credential | RRT-NPS, AE-C
-----------------------------------------------------
Telephone | 651-268-7587
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251V00000X
-----------------------------------------------------
Taxonomy Name | Voluntary or Charitable Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------