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Contact Information

PATJAC, INC.
4118 W DIVISION ST
SAINT CLOUD, MN56301-3706
 Phone: 320-252-2021
 Fax: 320-252-7416
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for PATJAC, INC.

NPI Number 1033118302
LBN Legal business name PATJAC, INC.
Authorized official PATRICK KANE - (FRANCHISE OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/19/2005
Last updated 07/21/2022 - About 4 years ago
Identifiers
MN Medicaid 383663100
Other C02754 WISCONSIN PHY
MN Other 65208PE BCBS
MN Other 65209PE BCBS
MN Other 102081 COLE
MN Other 65377 HP
MN Other 21-20963 MEDICA
MN Other 110495 UCARE
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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