Provider Demographics
NPI:1386047330
Name:TWIN CITIES HYPERBARICS, LLC
Entity type:Organization
Organization Name:TWIN CITIES HYPERBARICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FORD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-481-7047
Mailing Address - Street 1:12 LOST ROCK LN
Mailing Address - Street 2:
Mailing Address - City:NORTH OAKS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-2615
Mailing Address - Country:US
Mailing Address - Phone:651-481-7047
Mailing Address - Fax:
Practice Address - Street 1:3555 PLYMOUTH BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1389
Practice Address - Country:US
Practice Address - Phone:763-694-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31075261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical