Provider Demographics
NPI:1134150832
Name:FIRSTSOLUTIONS
Entity type:Organization
Organization Name:FIRSTSOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:BJORUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-740-2330
Mailing Address - Street 1:525 S LAKE AVE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2300
Mailing Address - Country:US
Mailing Address - Phone:218-740-2330
Mailing Address - Fax:218-740-4619
Practice Address - Street 1:1010 4TH ST
Practice Address - Street 2:
Practice Address - City:TWO HARBORS
Practice Address - State:MN
Practice Address - Zip Code:55616-1200
Practice Address - Country:US
Practice Address - Phone:218-834-7200
Practice Address - Fax:218-834-7220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRSTSOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-05
Last Update Date:2009-03-09
Deactivation Date:2008-08-12
Deactivation Code:
Reactivation Date:2008-10-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN802710200Medicaid
MNCD8414Medicare PIN
MNC08197Medicare PIN
MN243866Medicare Oscar/Certification