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NPI Code Detail

MEDICARE: HEALTH ACTIVATION SERVICES, PLLC

MEDICARE: HEALTH ACTIVATION SERVICES, PLLC
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
1261QX0100XOccupational Medicine Clinic/Center1748MN

General Provider Information

NPI Number : 1902035603
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH ACTIVATION SERVICES, PLLC
Provider Business Mailing Address
First Line : 4080 W BROADWAY AVE
Second Line : SUITE 200
City : ROBBINSDALE
State : MN
Zip : 55422-5604
Country : US
Telephone Number : 763-398-8835
Fax Number : 763-398-0670
Provider Business Practice Location Address
First Line : 7550 34TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55450-1124
Country : US
Telephone Number : 612-727-1167
Fax Number : 612-767-3525
Authorized Official
Title or Position : HR
Name : MS. JENNIFER DUNLEAVY
Credential :
Telephone Number : 612-398-8835
Provider Enumeration Date : 07/02/2009
Last Update Date : 03/01/2010

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