Provider Demographics
NPI:1265506661
Name:CGPS, INC
Entity Type:Organization
Organization Name:CGPS, INC
Other - Org Name:AFTERIMAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-404-2895
Mailing Address - Street 1:801 TWELVE OAKS CENTER DR
Mailing Address - Street 2:SUITE 816A
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4601
Mailing Address - Country:US
Mailing Address - Phone:952-404-2895
Mailing Address - Fax:952-404-2896
Practice Address - Street 1:801 TWELVE OAKS CENTER DR
Practice Address - Street 2:SUITE 816A
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4601
Practice Address - Country:US
Practice Address - Phone:952-404-2895
Practice Address - Fax:952-404-2896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1029729OtherPREFERREDONE
MN8211040OtherMEDICA INSURANCE
MN64970OtherHEALTHPARTNERS
MN32P02AFOtherBLUECROSS BLUESHIELD
MN117037OtherUCARE MINNESOTA
MN8211040OtherMEDICA INSURANCE