Provider Demographics
NPI:1174670970
Name:ACCORD
Entity Type:Organization
Organization Name:ACCORD
Other - Org Name:ACCORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKERING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-362-4420
Mailing Address - Street 1:1515 ENERGY PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-5229
Mailing Address - Country:US
Mailing Address - Phone:612-362-4400
Mailing Address - Fax:612-362-4479
Practice Address - Street 1:1515 ENERGY PARK DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-5229
Practice Address - Country:US
Practice Address - Phone:612-362-4400
Practice Address - Fax:612-362-4479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN824255100Medicaid