BOULDER POINTE EQUESTRIAN & EVENT CENTER LLC NPI 1730834896

NPI Information

NPI: 1730834896
Provider Name: BOULDER POINTE EQUESTRIAN & EVENT CENTER, LLC
Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
6612 189TH LN NW
ANOKA, MN
ZIP 55303
Phone: (952) 220-6028
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BOULDER POINTE EQUESTRIAN & EVENT CENTER, LLC is a point of service in Anoka, MN. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. BOULDER POINTE EQUESTRIAN & EVENT CENTER, LLC NPI is 1730834896. The provider is registered as an organization entity type.

The provider's business location address is:

6612 189TH LN NW
ANOKA, MN
ZIP 55303-519
Phone: (952) 220-6028

The provider's authorized official is Brandon Gustafson .
The authorized official title is Vice President and has the following contact phone number (952) 220-6028.

The enumeration date for this NPI number is 2/17/2022 and was last updated on 2/17/2022.

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	305S00000X	Point of Service				Yes

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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