Provider Demographics
NPI:1033214747
Name:PLATINUM VENTURES
Entity Type:Organization
Organization Name:PLATINUM VENTURES
Other - Org Name:HOUSECALLS NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHMIDTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-221-0722
Mailing Address - Street 1:16880 ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-3344
Mailing Address - Country:US
Mailing Address - Phone:952-221-0722
Mailing Address - Fax:952-926-2484
Practice Address - Street 1:16880 ROGERS RD
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-3344
Practice Address - Country:US
Practice Address - Phone:952-221-0722
Practice Address - Fax:952-926-2484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6041438332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5610950001Medicare ID - Type Unspecified