Provider Demographics
NPI:1598921975
Name:MINIMED DISTRIBUTION CORP.
Entity Type:Organization
Organization Name:MINIMED DISTRIBUTION CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR COMPLIANCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:WARD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-550-2017
Mailing Address - Street 1:18000 DEVONSHIRE ST
Mailing Address - Street 2:ATTN: ANGELA WARD JONES
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1219
Mailing Address - Country:US
Mailing Address - Phone:800-933-3322
Mailing Address - Fax:804-550-2796
Practice Address - Street 1:1501 42ND ST
Practice Address - Street 2:STE 350
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1005
Practice Address - Country:US
Practice Address - Phone:800-933-3322
Practice Address - Fax:804-550-2796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINIMED DISTRIBUTION CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-05
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies