Organization
UPPER MIDWEST ORGAN PROCUREMENT ORGANIZATION, INC.
Active
Other names
LifeSource
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER DAVID FARSTAD (CHIEF ADMINISTRATIVE OFFICER)
(612) 800-6100
Entity
Organization
Contact information
Practice address
2225 W RIVER RD, MINNEAPOLIS, MN 55411-2228
(612) 800-6100
Mailing address
2225 W RIVER RD, MINNEAPOLIS, MN 55411-2228
(612) 800-6100
Taxonomy
Speciality
Code
Description
License number
State
335U00000X
Organ Procurement Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24-P001
PALMETTO GBA
MN
Enumeration date
10/13/2021
Last updated
10/13/2021
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