Provider Demographics
NPI:1861499873
Name:MCKESSON MEDICAL-SURGICAL MEDINET INC.
Entity Type:Organization
Organization Name:MCKESSON MEDICAL-SURGICAL MEDINET INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BLANCHFILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-595-6130
Mailing Address - Street 1:8121 10TH AVE N
Mailing Address - Street 2:DEPARTMENT 312
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4401
Mailing Address - Country:US
Mailing Address - Phone:800-328-8111
Mailing Address - Fax:
Practice Address - Street 1:10220 SW GREENBURG RD
Practice Address - Street 2:2 LINCOLN CENTER, SUITE 410
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5503
Practice Address - Country:US
Practice Address - Phone:800-722-0422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00692293XMedicaid
ALMS726MNMedicaid
IA0914630Medicaid
OR158241Medicaid
CO66875544Medicaid
HI54506401Medicaid
MA1850083Medicaid
LA1667498Medicaid
CADME01751GMedicaid
DE0000687416Medicaid
AL00951070Medicaid
CO66875544Medicaid
0415130001Medicare NSC