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General NPI Number Information
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NPI Number | 1932167772
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Entity Type | Organization
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Legal Business Name | ALEXANDRIA EYE CLINIC P.A.
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 2600 JEFFERSON ST STE 200
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City | ALEXANDRIA
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State | MN
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Zip | 56308-3410
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Country | US
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Telephone | 320-762-2166
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Fax | 605-371-7199
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Provider Business Mailing Address
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Address Line | 3101 W 57TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-3162
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Country | US
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Telephone | 605-371-7100
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Fax | 605-371-7199
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Authorized Official
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Title or Position | CFO
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Name | MARK ALLEN SCHARNBERG
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Credential |
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Telephone | 605-359-9155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 20870
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License Number State | MN
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