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Contact Information

MINNESOTA OPTICAL LLC
19576 HOLT ST NW
ELK RIVER, MN55330
 Phone: 763-241-2083
 Fax: 763-241-3801
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MINNESOTA OPTICAL LLC

NPI # 1831303437
LBN Legal business name MINNESOTA OPTICAL LLC
Authorized official GARY TONSAGER - (CHIEF OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/10/2007
Last updated 03/09/2012 - About 14 years ago
Identifiers
MN Other 6627600001 DME
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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