Healthcare Provider Details

I. General information

NPI: 1821096348
Provider Name (Legal Business Name): RIDGEVIEW MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S MAPLE ST SUITE 2
WACONIA MN
55387-0096
US

IV. Provider business mailing address

501 S MAPLE ST SUITE 2
WACONIA MN
55387-0096
US

V. Phone/Fax

Practice location:
  • Phone: 952-442-2283
  • Fax: 952-442-2948
Mailing address:
  • Phone: 952-442-2283
  • Fax: 952-442-2948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIK JOHN SORENSEN
Title or Position: DIRECTOR
Credential:
Phone: 952-442-2283