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NORTH STAR PODIATRIC LAB INC. NPI 1962409995


NPI Information

NPI: 1962409995
Provider Name: NORTH STAR PODIATRIC LAB, INC.
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
13419 FENWAY BLVD N
SUITE 101
HUGO, MN
ZIP 55038
Phone: (651) 426-9388
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NORTH STAR PODIATRIC LAB, INC. is a prosthetic orthotic supplier in Hugo, MN. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. NORTH STAR PODIATRIC LAB, INC. NPI is 1962409995. The provider is registered as an organization entity type.

The provider's business location address is:

13419 FENWAY BLVD N
SUITE 101
HUGO, MN
ZIP 55038-465
Phone: (651) 426-9388
Fax: (651) 426-7450

The provider's authorized official is Terri Wagner .
The authorized official title is Certified Pedorthist and has the following contact phone number (651) 426-9388.

The enumeration date for this NPI number is 7/5/2005 and was last updated on 5/11/2020.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18214553OTHERMICRONESIAMEDICA PROVIDER NUMBER
226569NOOTHERMINNESOTABLUE CROSS PROVIDER NUMBE
3418173203OTHERMINNESOTAMETRO HEALTH PLAN PROV NU
4908817200MEDICAIDMICRONESIA
566OTHERMINNESOTAHEALTH PARTNERS PROVIDER

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: 5/5/2024

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