Organization · NPI-2

Allina Health System

Family Medicine · Fridley, MN

NPI number1912203365
StatusActive
Last updated in NPPESFeb 26, 2025

Details

NPI
1912203365
Entity type
Organization (NPI-2)
Legal business name
Allina Health System
Organization subpart
No
Enumeration date
Feb 2, 2011
Certification date
Feb 26, 2025
Last updated
Feb 26, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
261Q00000X Clinic/Center––

Other names

  • Allina Health Fridley Clinic (Doing Business As)

Practice location

500 Osborne Rd Ne Ste 150
Fridley, MN 55432-2770

Phone 763-786-6011 · Fax 763-236-2505

Mailing address

Po Box 43
Mail Route 10585
Minneapolis, MN 55440-0043

Phone 612-262-1166

Authorized official

Dominica Tallarico
Coo
6122222222

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