Gillette Children's Specialty Healthcare

NPI #1801109012 in Baxter, Minnesota

Provider Information

NPI Number: 1801109012
Entity Type: Organization
Organization Name: Gillette Children's Specialty Healthcare
Subpart: Yes (part of a larger organization)
Parent Organization: GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Primary Specialty: Durable Medical Equipment & Medical Supplies - Customized Equipment
Enumeration Date: Jul 16, 2010
Last Updated: Dec 13, 2019

Practice Location

Address: 15860 AUDUBON WAY
City: Baxter
State: Minnesota
ZIP Code: 56401-6943
Phone: (218) 824-5001

Authorized Official

Name: PATRICK NOLAN
Title: CFO
Phone: (651) 312-3105

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prosthetic/Orthotic Supplier	335E00000X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Durable Medical Equipment & Medical Supplies	332B00000X
Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment	332BC3200X	Primary

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