Provider Demographics
NPI:1821338484
Name:ON CALL MEDICAL INC
Entity Type:Organization
Organization Name:ON CALL MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-544-1000
Mailing Address - Street 1:5861 CEDAR LAKE RD S
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1481
Mailing Address - Country:US
Mailing Address - Phone:763-544-1000
Mailing Address - Fax:763-541-1076
Practice Address - Street 1:5861 CEDAR LAKE RD S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1481
Practice Address - Country:US
Practice Address - Phone:763-544-1000
Practice Address - Fax:763-541-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Multi-Specialty