Provider Demographics
NPI:1760898001
Name:MEDTRONIC CARE MANAGEMENT SERVICES, LLC
Entity Type:Organization
Organization Name:MEDTRONIC CARE MANAGEMENT SERVICES, LLC
Other - Org Name:CARDIOCOM, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP/GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:DODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-556-3405
Mailing Address - Street 1:7980 CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-8000
Mailing Address - Country:US
Mailing Address - Phone:888-243-8881
Mailing Address - Fax:888-320-8881
Practice Address - Street 1:7980 CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-8000
Practice Address - Country:US
Practice Address - Phone:888-243-8881
Practice Address - Fax:888-320-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNH300191694OtherMEDICARE PTAN