Provider Demographics
NPI:1639125503
Name:HEALTHEAST MEDICAL RESEARCH INSTITUTE
Entity Type:Organization
Organization Name:HEALTHEAST MEDICAL RESEARCH INSTITUTE
Other - Org Name:HEALTHEAST VADNAIS HEIGHTS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR NETWORK RELATIONS AO
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-672-6740
Mailing Address - Street 1:1055 CENTERVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-5033
Mailing Address - Country:US
Mailing Address - Phone:651-326-5900
Mailing Address - Fax:651-426-8935
Practice Address - Street 1:1055 CENTERVILLE CIR
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-5033
Practice Address - Country:US
Practice Address - Phone:651-326-5900
Practice Address - Fax:651-426-8935
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHEAST MEDICAL RESEARCH INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-25
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0841630003OtherMEDICARE PTAN
MN591013700Medicaid
MN591013700Medicaid