Provider Demographics
NPI:1164299137
Name:TWIN CITIES SURGERY CENTER, PA
Entity Type:Organization
Organization Name:TWIN CITIES SURGERY CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-841-2345
Mailing Address - Street 1:7211 OHMS LN
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2148
Mailing Address - Country:US
Mailing Address - Phone:952-204-3500
Mailing Address - Fax:952-856-2644
Practice Address - Street 1:1725 LEGACY PKWY E STE 110
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5434
Practice Address - Country:US
Practice Address - Phone:952-204-3500
Practice Address - Fax:952-856-2644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical