Provider Demographics
NPI:1679235584
Name:ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC
Entity Type:Organization
Organization Name:ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSURE ENROLLMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:TESKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-641-3423
Mailing Address - Street 1:ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC
Mailing Address - Street 2:7373 FRANCE AVE S, ST 404
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ALLINA HEALTH HEART AND VASCULAR SURGERY CENTER LLC
Practice Address - Street 2:7373 FRANCE AVE S, SUITE 404
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4534
Practice Address - Country:US
Practice Address - Phone:205-641-3423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical