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Contact Information

NORTHWEST EYE CENTER PA
1720 HY 59 SE
SUITE 1
THIEF RIVER FALLS, MN56701
 Phone: 218-681-3300
 Fax: 218-681-6733
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for NORTHWEST EYE CENTER PA

NPI Number 1831156645
LBN Legal business name NORTHWEST EYE CENTER PA
Authorized official CHRISTOPHER BORGEN - (CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 04/26/2006
Last updated 09/11/2008 - About 18 years ago
Identifiers
MN License # 2803
MN License # 2833
MN Medicaid 736145900
MN Medicaid 928102900
MN Other 289M4TJ BCBS
MN Other 46G79B0 BCBS
MN Other 644201041982 PREF
MN Other 644201030SS1 PREFERRED
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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