Provider Demographics
NPI:1215169909
Name:TRUSTEES OF THE HAMLINE UNIVERSITY OF MINNESOTA
Entity type:Organization
Organization Name:TRUSTEES OF THE HAMLINE UNIVERSITY OF MINNESOTA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FOR FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-523-2203
Mailing Address - Street 1:1536 HEWITT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-1205
Mailing Address - Country:US
Mailing Address - Phone:651-523-2204
Mailing Address - Fax:651-523-2820
Practice Address - Street 1:1513 ENGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-1284
Practice Address - Country:US
Practice Address - Phone:651-523-2204
Practice Address - Fax:651-523-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health