Provider Demographics
NPI:1700514320
Name:ALLINA HEALTH SURGERY CENTER- VADNAIS HEIGHTS LLC
Entity Type:Organization
Organization Name:ALLINA HEALTH SURGERY CENTER- VADNAIS HEIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-518-5185
Mailing Address - Street 1:1155 COUNTY ROAD E E STE 200
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55110-5191
Mailing Address - Country:US
Mailing Address - Phone:205-545-2572
Mailing Address - Fax:
Practice Address - Street 1:1155 COUNTY ROAD E E STE 200
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55110-5191
Practice Address - Country:US
Practice Address - Phone:205-545-2572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical