Organization
NORTHERN LAKES SURGERY CENTER LLC
Active
Organization
NORTHERN LAKES SURGERY CENTER LLC
Active
Other names
Northern Lake Surgery Center DME
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE BECKER (VP CORPORATE COMPLIANCE)
(218) 249-5555
Entity
Organization
Contact information
Practice address
4791 COUNTY ROAD 10 STE 101, MOOSE LAKE, MN 55767-9221
(218) 509-2100
Mailing address
4791 COUNTY ROAD 10 STE 101, MOOSE LAKE, MN 55767-9221
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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