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HEALTHSOURCE OF ST. PAUL- GRAND NPI 1154696813


NPI Information

NPI: 1154696813
Provider Name: HEALTHSOURCE OF ST. PAUL- GRAND
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1053 GRAND AVE
SUITE #114
SAINT PAUL, MN
ZIP 55105
Phone: (651) 292-9247
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HEALTHSOURCE OF ST. PAUL- GRAND is a clinic center in Saint Paul, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). HEALTHSOURCE OF ST. PAUL- GRAND NPI is 1154696813. The provider is registered as an organization entity type.

The provider's business location address is:

1053 GRAND AVE
SUITE #114
SAINT PAUL, MN
ZIP 55105-022
Phone: (651) 292-9247
Fax: (651) 292-9257

The provider's authorized official is Christopher Thomas Drews .
The authorized official title is President and has the following contact phone number (651) 292-9247.

The enumeration date for this NPI number is 3/14/2012 and was last updated on 3/30/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterDC4257MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.