Provider Demographics
NPI:1922446079
Name:LILSON HEALTH TECHNOLOGIES, LLC
Entity Type:Organization
Organization Name:LILSON HEALTH TECHNOLOGIES, LLC
Other - Org Name:ADVANCED HEALTH INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-201-7206
Mailing Address - Street 1:7801 E BUSH LAKE RD STE 475
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3121
Mailing Address - Country:US
Mailing Address - Phone:952-201-7206
Mailing Address - Fax:952-487-0149
Practice Address - Street 1:7801 E BUSH LAKE RD STE 475
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55439-3121
Practice Address - Country:US
Practice Address - Phone:952-201-7206
Practice Address - Fax:952-487-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies