Organization
NORTHWEST EYE CENTER PA
Active
Parent organization
NORTHWEST EYE CENTER PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST EYE CENTER PA
Authorized official
CHRISTOPHER J BORGEN OD (CEO)
(218) 681-3300
Entity
Organization
Contact information
Practice address
1720 HY 59 SE, SUITE 1, THIEF RIVER FALLS, MN 56701
(218) 681-3300
(218) 681-6733
Mailing address
PO BOX 505, 1720 HWY 59 SE SUITE 1, THIEF RIVER FALLS, MN 56701
(218) 681-3300
(218) 681-6733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2803
MN
152W00000X
Optometrist
2833
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
289M4TJ
BCBS
MN
01
—
46G79B0
BCBS
MN
01
—
644201030SS1
PREFERRED
MN
01
—
644201041982
PREF
MN
05
—
736145900
—
MN
05
—
928102900
—
MN
Enumeration date
04/26/2006
Last updated
09/11/2008
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