Provider Demographics
NPI:1033293857
Name:INFINITE HEALTH COLLABORATIVE, PA
Entity Type:Organization
Organization Name:INFINITE HEALTH COLLABORATIVE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:W
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-456-7316
Mailing Address - Street 1:3500 AMERICAN BLVD W STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-4442
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:
Practice Address - Street 1:3111 124TH AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-1793
Practice Address - Country:US
Practice Address - Phone:763-427-7300
Practice Address - Fax:763-427-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0477260016Medicare NSC