Provider Demographics
NPI:1568676450
Name:TOTAL MEDICAL SERVICES INC.
Entity Type:Organization
Organization Name:TOTAL MEDICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EMMANUEL
Authorized Official - Last Name:DAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MS
Authorized Official - Phone:651-765-4664
Mailing Address - Street 1:2499 RICE STREET SUITE#150
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3724
Mailing Address - Country:US
Mailing Address - Phone:651-765-4664
Mailing Address - Fax:651-765-4994
Practice Address - Street 1:2499 RICE ST STE 150
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3783
Practice Address - Country:US
Practice Address - Phone:651-765-4664
Practice Address - Fax:651-765-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1843361-2 DME302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ889735Medicaid
AZ889735Medicaid