Provider Demographics
NPI:1053895821
Name:SUNDOG ENTERPRISES
Entity type:Organization
Organization Name:SUNDOG ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZENK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-455-2585
Mailing Address - Street 1:2336 LEXINGTON AVE N
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-4343
Mailing Address - Country:US
Mailing Address - Phone:612-455-2585
Mailing Address - Fax:855-319-9875
Practice Address - Street 1:2336 LEXINGTON AVE N
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-4343
Practice Address - Country:US
Practice Address - Phone:612-455-2585
Practice Address - Fax:855-319-9875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty