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General NPI Number Information
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NPI Number | 1740252634
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Entity Type | Organization
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Legal Business Name | MINNEAPOLIS ENDOSCOPY ASC LLC
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 7600 PARKLAWN SOUTH SUITE 108
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City | EDINA
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State | MN
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Zip | 55435
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Country | US
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Telephone | 612-870-5750
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Fax | 612-870-5732
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Provider Business Mailing Address
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Address Line | 7600 PARKLAWN SOUTH SUITE 108
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City | EDINA
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State | MN
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Zip | 55435
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Country | US
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Telephone | 612-870-5750
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Fax | 612-870-5732
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Authorized Official
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Title or Position | CHIEF MANAGER OF LLC
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Name | MR. CHRISTOPHER A HOLDEN
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Credential |
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Telephone | 615-665-1283
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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 | 331034
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License Number State | MN
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