Healthcare Provider Details

I. General information

NPI: 1821049958
Provider Name (Legal Business Name): ASSOCIATED EYE CARE AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CURVE CREST BLVD
STILLWATER MN
55082
US

IV. Provider business mailing address

1719 TOWER DR W STE 100
STILLWATER MN
55082-7512
US

V. Phone/Fax

Practice location:
  • Phone: 651-275-3000
  • Fax: 651-275-3032
Mailing address:
  • Phone: 651-275-3050
  • Fax: 651-275-3027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number8216068
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GARY S SCHWARTZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 651-275-3000