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NPI 1720120645

OrganizationActive

Family Healthservices Minnesota, P.A

NPI 1720120645 · Non-Pharmacy Dispensing Site · White Bear Lake, MN

Provider details

NPI number: 1720120645
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Authorized official: Scott Peterson, Cfo
License: 38068 (MN)

Practice location

4786 Banning Ave

White Bear Lake, MN 55110-3264

Phone: (651) 426-6402

More MN providers

Mailing address

9276 Scranton Rd

San Diego, CA 92121-7701

Registry dates

Enumerated: 2007-02-14
Last updated: 2017-04-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Family Healthservices Minnesota, P.A — NPI 1720120645, White Bear Lake, MN | NPI Central