Provider Demographics
NPI:1821096348
Name:RIDGEVIEW MEDICAL CENTER
Entity Type:Organization
Organization Name:RIDGEVIEW MEDICAL CENTER
Other - Org Name:RIDGEVIEW HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-442-2283
Mailing Address - Street 1:501 S MAPLE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-0096
Mailing Address - Country:US
Mailing Address - Phone:952-442-2283
Mailing Address - Fax:952-442-2948
Practice Address - Street 1:501 S MAPLE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-0096
Practice Address - Country:US
Practice Address - Phone:952-442-2283
Practice Address - Fax:952-442-2948
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIDGEVIEW MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-08
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1296040001Medicare ID - Type UnspecifiedPROVIDER NUMBER