Provider Demographics
NPI:1376507061
Name:ANODYNE, INC.
Entity Type:Organization
Organization Name:ANODYNE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MARZOLF
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:952-546-5334
Mailing Address - Street 1:6024 BLUE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-9104
Mailing Address - Country:US
Mailing Address - Phone:952-546-5334
Mailing Address - Fax:952-546-2657
Practice Address - Street 1:6024 BLUE CIRCLE DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-9104
Practice Address - Country:US
Practice Address - Phone:952-546-5334
Practice Address - Fax:952-546-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN773232OtherAMERICA'S PPO
IA0987065Medicaid
MN104225OtherUCARE
39026OtherWAUSAU BENEFITS
MN403363900Medicaid
MN59255ANOtherBLUE CROSS BLUE SHIELD MN
MN8200161OtherMEDICA MSHO
MN403363900OtherMN COUNTY WAIVERED SVCS.
MN8200161OtherMEDICACHOICE
MN130869OtherHENNEPIN COUNTY WAIVERED
MN52190OtherSPECIALTY RISK SERVICES
76185C001OtherCHAMPUS
106040400OtherACS FEDERAL WORKERS COMP
MN1411901281OtherPRIME WEST
WI41682300Medicaid
MN1040355OtherPREFERREDONE
MN=========OtherACS DEPARTMENT OF LABOR