Provider Demographics
NPI:1891954582
Name:NORTH POINTE CLINIC
Entity Type:Organization
Organization Name:NORTH POINTE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ED DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-653-2528
Mailing Address - Street 1:6501 CITY WEST PKWY
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5605 E ROCKTON RD
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-7601
Practice Address - Country:US
Practice Address - Phone:952-653-2528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH POINTE CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site