Organization
MINNETONKA AMBULATORY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BIEN (CFO)
(612) 961-1863
Entity
Organization
Contact information
Practice address
15450 HIGHWAY 7, STE 200, MINNETONKA, MN 55345-3522
(763) 581-8950
Mailing address
710 COMMERCE DR STE 200, WOODBURY, MN 55125-4925
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24C0001088
MEDICARE CCN
—
Enumeration date
01/15/2015
Last updated
01/07/2022
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