Northwest Eye Clinic, Llc

LBN: Northwest Eye Clinic, Llc
Northwest Eye Clinic, Llc is an health care organization with primary practice located at 2601 39Th Ave Ne Ste 1 , St. Anthony MN 55421. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Northwest Eye Clinic, Llc can be contacted via phone (763) 416-7600, or through Pettengill, Kelly via phone (763) 416-7629.

Contact Information

Primary practice address
2601 39Th Ave Ne Ste 1 St. Anthony MN 55421
Phone: (763) 416-7600
Fax: (763) 416-7634
Website:
Map and Directions
Authorized official contact:
Name: Pettengill, Kelly
Phone: (763) 416-7629

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 360 Minnesota

Profile Details

NPI number 1255417002
LBN Legal business name Northwest Eye Clinic, Llc
DBA Doing business as
Authorized official Pettengill, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date Oct 27th, 2006
Last updated Mar 18th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255417002 NPPES
Minnesota MEDICAID 298616700

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