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HEALTH SOURCE OF WOODBURY PA NPI 1447401971


NPI Information

NPI: 1447401971
Provider Name: HEALTH SOURCE OF WOODBURY PA
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
7060 VALLEY CREEK PLZ STE 121
WOODBURY, MN
ZIP 55125
Phone: (651) 735-8646
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HEALTH SOURCE OF WOODBURY PA is a clinic center in Woodbury, MN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). HEALTH SOURCE OF WOODBURY PA NPI is 1447401971. The provider is registered as an organization entity type.

The provider's business location address is:

7060 VALLEY CREEK PLZ STE 121
WOODBURY, MN
ZIP 55125-269
Phone: (651) 735-8646

The provider's authorized official is Jeffrey J. Wisdo .
The authorized official title is Owner and has the following contact phone number (651) 735-8646.

The enumeration date for this NPI number is 10/2/2008 and was last updated on 10/2/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.