Healthcare Provider Details

I. General information

NPI: 1174882039
Provider Name (Legal Business Name): HI HEALTHINNOVATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 12/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11020 OPTUM CIR MN 102-0200
EDEN PRAIRIE MN
55344-2503
US

IV. Provider business mailing address

PO BOX 356
MINNEAPOLIS MN
55440-0356
US

V. Phone/Fax

Practice location:
  • Phone: 952-205-1173
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number965202
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberBHAD7641
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberHD1100083
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number15000020889
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberD01019
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateIA
# 7
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: LISA TSENG
Title or Position: C.E.O
Credential: M.D
Phone: 952-833-6625