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Organization
ACE MEDICAL CENTER, LLC
Active
Organization
ACE MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINE W NDIFOR CNP RN (ADMINISTRATOR)
(617) 413-4952
Entity
Organization
Contact information
Practice address
10259 ENGLEWOOD DR, EDEN PRAIRIE, MN 55347-4623
(617) 413-4952
Mailing address
PO BOX 44044, EDEN PRAIRIE, MN 55344-1044
(617) 413-4952
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QP0904X
Federal Public Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
3233
MN
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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