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General NPI Number Information
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NPI Number | 1790855641
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Entity Type | Organization
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Legal Business Name | CITY OF WOODBURY
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 2100 RADIO DR
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City | WOODBURY
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State | MN
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Zip | 55125-9598
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Country | US
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Telephone | 651-714-3500
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Fax | 651-714-3501
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Provider Business Mailing Address
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Address Line | 8301 VALLEY CREEK RD
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City | WOODBURY
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State | MN
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Zip | 55125-2320
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Country | US
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Telephone | 651-714-3500
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Fax | 651-714-3501
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Authorized Official
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Title or Position | CITY ADMINISTRATOR
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Name | CLINTON GRIDLEY
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Credential |
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Telephone | 651-714-3521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | MN-0275
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License Number State | MN
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