| Gillette Children's Specialty Healthcare | |
|
1420 London Rd Duluth MN 55805-2433 | |
| (218) 728-6160 | |
| (218) 724-6982 |
| Full Name | Gillette Children's Specialty Healthcare |
|---|---|
| Speciality | Prosthetic/Orthotic Supplier |
| Location | 1420 London Rd, Duluth, Minnesota |
| Authorized Official Name and Position | Patrick Nolan (CFO) |
| Authorized Official Contact | 6513123105 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gillette Children's Specialty Healthcare 200 University Ave E Saint Paul MN 55101-2507 Ph: (651) 291-2848 | Gillette Children's Specialty Healthcare 1420 London Rd Duluth MN 55805-2433 Ph: (218) 728-6160 |
| NPI Number | 1477612604 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 12/13/2019 |
| Medicare PECOS PAC ID | 0547169211 |
|---|---|
| Medicare Enrollment ID | O20210119001812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477612604 | NPI | - | NPPES |
| 11003700 | Medicaid | WI | |
| 235422100 | Medicaid | MN | |
| 1111HGI | Other | BLUE CROSS BLUE SHIELD | |
| 103632000 | Medicaid | MN | |
| 41683100 | Medicaid | WI |
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