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General NPI Number Information
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NPI Number | 1326761792
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Entity Type | Organization
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Legal Business Name | SOUTHWEST SURGICAL CENTER LLC
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 8100 W 78TH ST STE 220
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City | EDINA
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State | MN
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Zip | 55439-2568
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Country | US
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Telephone | 952-914-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 W 78TH ST STE 220
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City | EDINA
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State | MN
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Zip | 55439-2568
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Country | US
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Telephone | 952-914-8400
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Fax |
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Authorized Official
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Title or Position | GROUP VICE PRESIDENT OPERATIONS
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Name | MICHAEL MILLER
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Credential |
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Telephone | 612-518-5185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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