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NPI Code Detail

MEDICARE: PEDIATRIC HOME RESPIRATORY SERVICES LLC

MEDICARE: PEDIATRIC HOME RESPIRATORY SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
2332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2239L7PEOTHERMNBCBS-MN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629141213
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC HOME RESPIRATORY SERVICES LLC
Provider Business Mailing Address
First Line : 2800 CLEVELAND AVE N
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1126
Country : US
Telephone Number : 651-642-1825
Fax Number : 651-638-0690
Provider Business Practice Location Address
First Line : 2800 CLEVELAND AVE N
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1126
Country : US
Telephone Number : 651-642-1825
Fax Number : 651-638-0690
Authorized Official
Title or Position : CHIEF ADMINISTRATIVE OFFICER
Name : CAMEO KAE ZEHNDER
Credential :
Telephone Number : 651-642-1825
Provider Enumeration Date : 11/15/2006
Last Update Date : 02/02/2026

Similar Medicare Providers

1932266632 — PEDIATRIC HOME RESPIRATORY SERVICES LLC
Practice Location Address:
2800 CLEVELAND AVE N
ROSEVILLE, MN
55113-1126
Practice Phone: 651-642-1825
Practice Fax: 651-638-0980
1144722190 — PEDIATRIC HOME RESPIRATORY SERVICES LLC
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2800 CLEVELAND AVE N
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1285706911 — PEDIATRIC HOME RESPIRATORY SERVICES LLC
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2800 CLEVELAND AVE N
ROSEVILLE, MN
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1427103464 — STEVE MICHAEL LAFOND PHARMD
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2800 CLEVELAND AVE N
ROSEVILLE, MN
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Practice Fax:
1942342423 — JILL ANDERSON
Practice Location Address:
2800 CLEVELAND AVE N
ROSEVILLE, MN
55113-1126
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1265574750 — ROCHELLE AUSTIN
Practice Location Address:
2800 CLEVELAND AVE N
ROSEVILLE, MN
55113-1126
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Practice Fax:

Directions to “PEDIATRIC HOME RESPIRATORY SERVICES LLC ” Practice Location

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