Provider Demographics
NPI:1851741938
Name:BENOVATE, INC.
Entity Type:Organization
Organization Name:BENOVATE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-455-7120
Mailing Address - Street 1:901 N 3RD ST
Mailing Address - Street 2:SUITE 332
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1001
Mailing Address - Country:US
Mailing Address - Phone:855-236-3411
Mailing Address - Fax:612-455-7101
Practice Address - Street 1:901 N 3RD ST
Practice Address - Street 2:SUITE 332
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-1001
Practice Address - Country:US
Practice Address - Phone:855-236-3411
Practice Address - Fax:612-455-7101
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENOVATE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management