MEDICARE: AMERICAN LUNG ASSOCIATION OF THE UPPER MIDWEST

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
1	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1982839791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN LUNG ASSOCIATION OF THE UPPER MIDWEST

Provider Business Mailing Address
First Line	:	490 CONCORDIA AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55103-2412
Country	:	US
Telephone Number	:	651-227-8014
Fax Number	:	651-227-5459

Provider Business Practice Location Address
First Line	:	490 CONCORDIA AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55103-2412
Country	:	US
Telephone Number	:	651-227-8014
Fax Number	:	651-227-5459

Authorized Official
Title or Position	:	MANAGER, RESPIRATORY HEALTH
Name	:	HEATHER STEFFENS
Credential	:	RRT-NPS, AE-C
Telephone Number	:	651-268-7587

Provider Enumeration Date	:	05/22/2009
Last Update Date	:	05/22/2009

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