Organization
CHASKA MEDICAL CENTER
Active
Other names
Crossroads Medical Centers PA
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A REKOW (ADMINISTRATOR)
(952) 361-0529
Entity
Organization
Contact information
Practice address
14033 COMMERCE AVE NE, PRIOR LAKE, MN 55372-1438
(952) 447-1700
(952) 447-1708
Mailing address
14033 COMMERCE AVE NE, PRIOR LAKE, MN 55372
(952) 447-1700
(952) 447-1708
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
153
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51172CH
BCBS
MN
Enumeration date
01/23/2007
Last updated
08/22/2020
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