Provider Demographics
NPI:1417214792
Name:EDINA URGENT CARE
Entity Type:Organization
Organization Name:EDINA URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-927-7337
Mailing Address - Street 1:7025 FRANCE AVE S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4202
Mailing Address - Country:US
Mailing Address - Phone:952-927-8725
Mailing Address - Fax:952-927-8610
Practice Address - Street 1:7025 FRANCE AVE S
Practice Address - Street 2:SUITE 102
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4202
Practice Address - Country:US
Practice Address - Phone:952-927-8725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1844261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care