Provider Demographics
NPI:1265688386
Name:MINIMED DISTRIBUTION CORP.
Entity Type:Organization
Organization Name:MINIMED DISTRIBUTION CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR COMPLIANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-262-6492
Mailing Address - Street 1:18000 DEVONSHIRE ST
Mailing Address - Street 2:ATTN: ANGELA WARD
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1219
Mailing Address - Country:US
Mailing Address - Phone:800-933-3322
Mailing Address - Fax:818-576-6228
Practice Address - Street 1:10801 MASTIN ST
Practice Address - Street 2:STE 340
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1669
Practice Address - Country:US
Practice Address - Phone:800-933-3322
Practice Address - Fax:818-576-6228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINIMED DISTRIBUTION CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies