Provider Demographics
NPI:1750188488
Name:EMERGENCY PHYSICIANS PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:EMERGENCY PHYSICIANS PROFESSIONAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-857-1501
Mailing Address - Street 1:4300 MARKET PTE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5435
Mailing Address - Country:US
Mailing Address - Phone:952-857-1501
Mailing Address - Fax:
Practice Address - Street 1:6110 GOLDEN HILLS DR
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55416-1020
Practice Address - Country:US
Practice Address - Phone:952-835-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGENCY PHYSICIANS PROFESSIONAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-28
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care