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NPI Code Detail

MEDICARE: LIFEVIEW CARE,PLLC

MEDICARE: LIFEVIEW CARE,PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center1809MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11609853530OTHERPROVIDER NPI

General Provider Information

NPI Number : 1356639058
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFEVIEW CARE,PLLC
Provider Business Mailing Address
First Line : 3600 AMERICAN BLVD W
Second Line : SUITE 225
City : BLOOMINGTON
State : MN
Zip : 55431-1079
Country : US
Telephone Number : 952-500-3337
Fax Number : 855-715-1907
Provider Business Practice Location Address
First Line : 3600 AMERICAN BLVD W
Second Line : SUITE 225
City : BLOOMINGTON
State : MN
Zip : 55431-1079
Country : US
Telephone Number : 952-500-3337
Fax Number : 855-715-1907
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. THOMAS HARMAN
Credential : M.D.
Telephone Number : 952-426-6427
Provider Enumeration Date : 07/14/2011
Last Update Date : 07/14/2011

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