Provider Demographics
NPI:1821232653
Name:PINDROP HEARING OF SOUTH CENTRAL MINNESOTA
Entity Type:Organization
Organization Name:PINDROP HEARING OF SOUTH CENTRAL MINNESOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:952-746-8688
Mailing Address - Street 1:205 LEWIS ST S
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-1459
Mailing Address - Country:US
Mailing Address - Phone:952-746-8688
Mailing Address - Fax:952-746-8687
Practice Address - Street 1:205 LEWIS ST S
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-1459
Practice Address - Country:US
Practice Address - Phone:952-746-8688
Practice Address - Fax:952-746-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2640332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment