Organization
LIFESCAN MINNESOTA STAND UP MRI LLC
Active
Parent organization
LIFESCAN MINNESOTA STAND UP MRI LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESCAN MINNESOTA STAND UP MRI LLC
Authorized official
MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
(502) 403-1401
Entity
Organization
Contact information
Practice address
5023 EXCELSIOR BLVD, STE 9B, ST LOUIS PARK, MN 55416-3013
(952) 920-8860
(952) 920-8869
Mailing address
5023 EXCELSIOR BLVD, STE 9B, ST LOUIS PARK, MN 55416-3013
(952) 920-8860
(952) 920-8869
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377120200
—
MN
Enumeration date
05/24/2005
Last updated
07/07/2008
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