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Contact Information

NORTHWEST EYE CLINIC, P.A.
5657 DULUTH ST
GOLDEN VALLEY, MN55422-4054
 Phone: 763-416-7600
 Fax: 763-542-9708
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for NORTHWEST EYE CLINIC, P.A.

NPI Number 1346326196
LBN Legal business name NORTHWEST EYE CLINIC, P.A.
Authorized official AUDREY BERG - (BUSINESS OFFICE SUPERVISOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/27/2006
Last updated 01/22/2009 - About 17 years ago
Identifiers
MN License # 360
MN Medicaid 290445400
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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