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Contact Information

GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
200 UNIVERSITY AVE E
SAINT PAUL, MN55101-2507
 Phone: 651-726-2890
 Fax: 651-726-2848
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for GILLETTE CHILDREN'S SPECIALTY HEALTHCARE

NPI # 1386758373
LBN Legal business name GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Authorized official VANESSA HARTZLER - (MANAGER PAYER RELATIONS AND STRATEG)
Entity Organization
Organization subpart 1 No
Enumeration date 08/18/2006
Last updated 09/14/2021 - About 5 years ago
Identifiers
MN License # 262713
IA Medicaid 1678053F
KS Medicaid 100440690B
MN Medicaid 376978000
MT Medicaid 1386758373
ND Medicaid 21513
NE Medicaid 10025653700
SD Medicaid 8535290
WI Medicaid 33295600
Other 2049091 PK
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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