Provider Demographics
NPI:1821410143
Name:CADAN
Entity Type:Organization
Organization Name:CADAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AT CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-278-0559
Mailing Address - Street 1:4131 OLD SIBLEY MEMORIAL HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1947
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4131 OLD SIBLEY MEMORIAL HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-1947
Practice Address - Country:US
Practice Address - Phone:651-456-5760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2144362332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN332BC3200XMedicaid