Provider Demographics
NPI:1871964296
Name:MEDTRONIC MONITORING INC
Entity type:Organization
Organization Name:MEDTRONIC MONITORING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND GENERAL MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODHEART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-526-2518
Mailing Address - Street 1:PO BOX 74008550
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-8550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 GATEWAY BLVD STE 275
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-7409
Practice Address - Country:US
Practice Address - Phone:650-238-3700
Practice Address - Fax:408-790-9375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center