FAMILY HEALTHSERVICES MINNESOTA, P.A (NPI# 1720120645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720120645 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTHSERVICES MINNESOTA, P.A |
| Practice Address |
4786 Banning Ave White Bear Lake MN 55110-3264 |
| Mailing Address |
9276 Scranton Rd Suite 100 San Diego CA 92121-7701 |
| Practice Telephone | 6514266402 |
| Mailing Telephone | 8586252990 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2017-04-11 |
| Authorized Official Name | SCOTT PETERSON (CFO) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 38068 | MN | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811039050 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 3550 Labore Rd, Suite 7, Saint Paul, MN 55110-7505 | 2007-02-13 |
| 1265574198 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 3220 Bellaire Ave, White Bear Lake, MN 55110-5854 | 2007-02-14 |
| 1366584526 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 1540 Randolph Ave, Saint Paul, MN 55105-2535 | 2007-02-13 |
| 1841332087 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 2716 Upper Afton Rd E, Maplewood, MN 55119-4780 | 2007-02-13 |
| 1588706378 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 2601 Centennial Dr, 100, Saint Paul, MN 55109-3041 | 2007-02-12 |
| 1417098278 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 1050 Larpenteur Ave W, Saint Paul, MN 55113-6556 | 2007-02-12 |
| 1518009307 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 2980 Buckley Way, Inver Grove Heights, MN 55076-2017 | 2007-02-12 |
| 1538201280 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 911 Maryland Ave E, Saint Paul, MN 55106-2647 | 2007-02-12 |
| 1447391420 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 404 Highway 96 W, Shoreview, MN 55126-1901 | 2007-02-10 |
| 1568503795 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 8325 City Centre Dr, Woodbury, MN 55125-3323 | 2007-02-09 |
| Street Address |
4786 BANNING AVE |
| City | WHITE BEAR LAKE |
| State | MN |
| Zip Code | 55110-3264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831141886 | Ann M Barry | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110 | 2006-05-17 |
| 1346713476 | Maria Elizabeth Cook | Physician Assistant | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2019-01-11 |
| 1982077061 | Nicole Altstatt | Nurse Practitioner | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2015-11-11 |
| 1730520008 | Nicole Marie Harvey | Physician Assistant | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2013-07-15 |
| 1366751562 | Minnesota Institute for Pain Management, LLC | Physical Medicine & Rehabilitation | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2010-10-05 |
| 1356668123 | Stacy Marie Smith | Physician Assistant | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2010-05-03 |
| 1639359359 | Family Healthservices Minnesota, P.a. | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2007-11-09 |
| 1871710988 | Minnhealth Family Physicians, P.a. | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2007-04-19 |
| 1972510634 | David C Thorson | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2006-08-02 |
| 1063428746 | Carol K Stark | Family Medicine | 4786 Banning Ave, White Bear Lake, MN 55110-3264 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
| 1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
| 1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
| 1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
| 1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
| 1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
| 1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
| 1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
| 1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
| Find all providers in zip 55110 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265574198 | Family Healthservices Minnesota, P.a | Non-Pharmacy Dispensing Site | 3220 Bellaire Ave, White Bear Lake, MN 55110-5854 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1851856504 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 2945 Hazelwood St Ste 230, Maplewood, MN 55109-1241 | 2019-02-07 |
| 1417450651 | Cerner Health Connections, Inc | Non-Pharmacy Dispensing Site | 4001 Lexington Ave N Ste C2-435, Arden Hills, MN 55126-2934 | 2018-03-14 |
| 1316461593 | Fairview Pharmacy Service LLC | Non-Pharmacy Dispensing Site | 7250 France Ave S Ste 410, Edina, MN 55435-4314 | 2017-07-31 |
| 1346653052 | Advanced Spine and Pain Clinics of Mn, LLC | Non-Pharmacy Dispensing Site | 308 Brighton Ave, Suite D, Buffalo, MN 55313-2303 | 2014-06-10 |
| 1407296148 | Group Health Plan Inc | Non-Pharmacy Dispensing Site | 1833 2nd Ave, Anoka, MN 55303-2432 | 2013-06-26 |
| 1295178135 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 6440 Nicollet Ave South, Richfield, MN 55423-1613 | 2013-04-10 |
| 1992148845 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | 2450 Riverside Ave South, Minneapolis, MN 55454-1400 | 2013-04-10 |
| 1083984876 | Mayo Clinic Health System-southeast Minnesota Region | Non-Pharmacy Dispensing Site | 32021 County 24 Boulevard, Cannon Falls, MN 55009-1824 | 2012-01-10 |
| 1255623765 | Mankato Clinic, Ltd | Non-Pharmacy Dispensing Site | 305 Main St Ne, Mapleton, MN 56065 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | WHITE BEAR LAKE |
| Zip Code | 55110 |
Please comment or provide details below to improve the information on FAMILY HEALTHSERVICES MINNESOTA, P.A.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.