MINNESOTA EYE INSTITUTE SURGERY CENTER LLC NPI 1003802950

NPI Information

NPI: 1003802950
Provider Name: MINNESOTA EYE INSTITUTE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 24D2052647

Address:
3401 S BROADWAY
ALEXANDRIA, MN
ZIP 56308
Phone: (320) 759-2020
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MINNESOTA EYE INSTITUTE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Alexandria, MN. MINNESOTA EYE INSTITUTE SURGERY CENTER, LLC NPI is 1003802950. The provider is registered as an organization entity type.

The provider's business location address is:

3401 S BROADWAY
ALEXANDRIA, MN
ZIP 56308-477
Phone: (320) 759-2020
Fax: (320) 759-2424

The provider's authorized official is Kent Arthur Carlson .
The authorized official title is Owner and has the following contact phone number (320) 759-2020.

The CLIA number assigned to this NPI record is 24D2052647 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2005 and was last updated on 9/24/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical		MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C05220	MEDICARE PIN	CALIFORNIA
2	382112900	MEDICAID	MINNESOTA

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: 5/5/2024

NPI Synchronization or Removal

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