| Gillette Children's Healthcare Mntk | |
|
6060 Clearwater Dr Minnetonka MN 55343-9442 | |
| (952) 936-0977 | |
| (952) 936-0944 |
| Full Name | Gillette Children's Healthcare Mntk |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 6060 Clearwater Dr, Minnetonka, Minnesota |
| Authorized Official Name and Position | Patrick Nolan (CFO) |
| Authorized Official Contact | 6513123105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gillette Children's Healthcare Mntk 200 University Ave E Saint Paul MN 55101-2507 Ph: (651) 291-2848 | Gillette Children's Healthcare Mntk 6060 Clearwater Dr Minnetonka MN 55343-9442 Ph: (952) 936-0977 |
| NPI Number | 1598824880 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 12/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598824880 | NPI | - | NPPES |
| 594130000 | Medicaid | MN | |
| 41683100 | Medicaid | WI | |
| 815488000 | Medicaid | MN | |
| 1111HGI | Other | BLUE CROSS BLUE SHIELD | |
| 11003700 | Medicaid | WI |
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