Provider Demographics
NPI:1437348117
Name:MEMORIAL BLOOD CENTERS
Entity Type:Organization
Organization Name:MEMORIAL BLOOD CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, MEDICAL AND QUALITY AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:JED
Authorized Official - Middle Name:B
Authorized Official - Last Name:GORLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:651-332-7284
Mailing Address - Street 1:737 PELHAM BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1739
Mailing Address - Country:US
Mailing Address - Phone:651-332-7000
Mailing Address - Fax:
Practice Address - Street 1:737 PELHAM BLVD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1739
Practice Address - Country:US
Practice Address - Phone:651-332-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable