COLUMBIA PARK MEDICAL GROUP, PA; NPI #1336246735

Contact Information

COLUMBIA PARK MEDICAL GROUP, PA

6341 UNIVERSITY AVE NE
FRIDLEY, MN 55432-4946

Phone: 763-572-5710
Fax: 763-586-5888
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for COLUMBIA PARK MEDICAL GROUP, PA

NPI Number 1336246735

LBN Legal business name COLUMBIA PARK MEDICAL GROUP, PA

Authorized official JOEN CONDON - (CHIEF FINANCIAL OFFICER)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 09/20/2006

Last updated 11/13/2007 - About 19 years ago

Identifiers

MN	Other	02071BR	BCBS OF MN
MN	Other	610	HEALTHPARTNERS
MN	Other	98-01409	MEDICA CLINIC NUMBER
MN	Other	98-66093	MEDICA URGENT CARE
MN	Other	CT1003	MEDICARE RAILROAD
MN	Other	104021	UCARE MN
MN	Other	UC0002	UCARE URGENT CARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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