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Contact Information

COLUMBIA PARK MEDICAL GROUP, PA
4000 CENTRAL AVE NE
COLUMBIA HEIGHTS, MN55421-2968
 Phone: 763-572-5710
 Fax: 763-782-8100
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Eyewear Supplier

332H00000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for COLUMBIA PARK MEDICAL GROUP, PA

NPI Number 1619077575
LBN Legal business name COLUMBIA PARK MEDICAL GROUP, PA
Authorized official JOHN WEIR - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/22/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN Other 5C728CO BCBS EYEWARE
MN Other 21-00010 EYECRAFT LAB
MN Other 21139 MEDICA EYEWARE
MN Other 126907 UCARE EYEWARE
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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