Provider Demographics
NPI:1386324226
Name:THE ALIVENESS PROJECT, INC.
Entity type:Organization
Organization Name:THE ALIVENESS PROJECT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBUREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-822-7946
Mailing Address - Street 1:3808 NICOLLET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1304
Mailing Address - Country:US
Mailing Address - Phone:612-484-3113
Mailing Address - Fax:612-677-3098
Practice Address - Street 1:3808 NICOLLET AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1304
Practice Address - Country:US
Practice Address - Phone:612-822-7946
Practice Address - Fax:612-677-3098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ALIVENESS PROJECT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-24
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy