Provider Demographics
NPI:1518574854
Name:GINGER SPICE HEALTH, LLC
Entity Type:Organization
Organization Name:GINGER SPICE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:PRIYANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:651-324-3175
Mailing Address - Street 1:3464 RIDGESTONE WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-5009
Mailing Address - Country:US
Mailing Address - Phone:651-324-3175
Mailing Address - Fax:
Practice Address - Street 1:3464 RIDGESTONE WAY
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-5009
Practice Address - Country:US
Practice Address - Phone:651-324-3175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty