Healthcare Provider Details

I. General information

NPI: 1417214792
Provider Name (Legal Business Name): EDINA URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7025 FRANCE AVE S SUITE 102
EDINA MN
55435-4202
US

IV. Provider business mailing address

7025 FRANCE AVE S SUITE 102
EDINA MN
55435-4202
US

V. Phone/Fax

Practice location:
  • Phone: 952-927-8725
  • Fax:
Mailing address:
  • Phone: 952-927-8725
  • Fax: 952-927-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number1844
License Number StateMN

VIII. Authorized Official

Name: VICKI THOMSON
Title or Position: OWNER
Credential: MD
Phone: 952-927-7337