Provider Demographics
NPI:1629519020
Name:SAINT PAUL MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:SAINT PAUL MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HASEEB
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-217-8173
Mailing Address - Street 1:445 MINNESOTA ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2190
Mailing Address - Country:US
Mailing Address - Phone:651-217-8173
Mailing Address - Fax:651-571-4897
Practice Address - Street 1:445 MINNESOTA ST
Practice Address - Street 2:SUITE 1500
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2190
Practice Address - Country:US
Practice Address - Phone:651-217-8173
Practice Address - Fax:651-571-4897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-17
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies