Organization
BRAINERD LAKES SURGERY CENTER L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SCHWENDEMAN (ADMINISTRATOR)
(218) 822-2415
Entity
Organization
Contact information
Practice address
13114 ISLE DR, BAXTER, MN 56425-8330
(218) 822-2400
(218) 822-2401
Mailing address
13114 ISLE DR, BAXTER, MN 56425-8330
(218) 822-2400
(218) 822-2401
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
328113
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0L00BR
BCBS
MN
01
—
1043422
PREFERRED ONE
MN
01
—
105730
HEALTHPARTNERS
MN
01
—
181112
UCARE
MN
05
—
201937000
—
MN
01
—
2314785
AMERICAS PPO ARAZ
MN
01
—
6800051
SELECT CARE
MN
01
—
P00205406
PALMETTO GBA
MN
Enumeration date
09/30/2005
Last updated
10/24/2024
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