Provider Demographics
NPI:1598343592
Name:SPECIALYSTS, INC.
Entity Type:Organization
Organization Name:SPECIALYSTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF REIMBURSEMENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-429-6951
Mailing Address - Street 1:2725 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-8680
Mailing Address - Country:US
Mailing Address - Phone:855-753-8298
Mailing Address - Fax:
Practice Address - Street 1:1250 MOORE LAKE DR E STE 130
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-5135
Practice Address - Country:US
Practice Address - Phone:855-753-8298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local