Provider Demographics
NPI:1942380613
Name:ADVANCED HEALTH PA
Entity Type:Organization
Organization Name:ADVANCED HEALTH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:HEBEISEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:763-571-9499
Mailing Address - Street 1:6280 HWY 65
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432
Mailing Address - Country:US
Mailing Address - Phone:763-571-9499
Mailing Address - Fax:763-502-0364
Practice Address - Street 1:6280 HWY 65
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432
Practice Address - Country:US
Practice Address - Phone:763-571-9499
Practice Address - Fax:763-502-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN665950OtherAMERICAS PPO
GA665950OtherDEFINITY HEALTH
MN230321OtherCHIROCARE
IL47676807801OtherCIGNA HELATH CARE
UT230321OtherUNITED HEALTHCARE
MN767527500Medicaid
MN01005230OtherPREFERED ONE
MN1026232OtherPAS
CA231414OtherAMERICAN SPECIALTY HEALTH
TX4448225OtherMEDICA
MN237P3HEOtherBLUE CROSS BLUE SHEILD
MN4425650OtherMEDICA
MNCC00773OtherCHIROCARE OF MN
MN377OtherHEALTH SERVICE MGMT
MN01005230OtherPREFERED ONE
MN230321OtherCHIROCARE