Provider Demographics
NPI:1073883666
Name:PARK POINT INC
Entity Type:Organization
Organization Name:PARK POINT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSAGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-693-8496
Mailing Address - Street 1:7362 UNIVERSITY AVE NE STE 211
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3151
Mailing Address - Country:US
Mailing Address - Phone:763-205-3891
Mailing Address - Fax:612-206-8284
Practice Address - Street 1:7362 UNIVERSITY AVE NE STE 211
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3151
Practice Address - Country:US
Practice Address - Phone:763-205-3891
Practice Address - Fax:612-206-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251J00000X
MN2638183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2431207OtherNCPDP PROVIDER IDENTIFICATION NUMBER