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General NPI Number Information
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NPI Number | 1952405284
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Entity Type | Organization
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Legal Business Name | CHILDRENS HEALTH CARE SERVICES INC
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 10/31/2022
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Provider Practice Location Address
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Address Line | 6050 CLEARWATER DRIVE CHILDRENS MINNETONKA AMBULATORY SURGICAL CTR
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City | MINNETONKA
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State | MN
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Zip | 55343
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Country | US
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Telephone | 952-930-8600
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Fax | 952-930-8650
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Provider Business Mailing Address
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Address Line | 5901 LINCOLN DR CBC-2-REV/PE
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City | EDINA
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State | MN
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Zip | 55436-1611
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Country | US
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Telephone | 952-992-5691
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Fax | 952-992-6917
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Authorized Official
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Title or Position | SR. VP AND CHIEF FINANCIAL OFFICER
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Name | BRENDA LU ALEXANDER MCCORMICK
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Credential |
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Telephone | 612-813-6129
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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 | 331022
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License Number State | MN
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