Healthcare Provider Details
I. General information
NPI: 1679452973
Provider Name (Legal Business Name): HEALTHEAST WOODWINDS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1925 WOODWINDS DR
WOODBURY MN
55125-4445
US
IV. Provider business mailing address
1700 UNIVERSITY AVE W
SAINT PAUL MN
55104-3727
US
V. Phone/Fax
- Phone: 855-324-7843
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
CHARLES
GAYLORD
Title or Position: CFO
Credential:
Phone: 651-895-3054