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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