1699711143 NPI number — UNIVERSITY ANESTHESIA PROVIDERS, LLC

Table of content: (NPI 1699711143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699711143 NPI number — UNIVERSITY ANESTHESIA PROVIDERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY ANESTHESIA PROVIDERS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
M HEALTH FAIRVIEW UNIVERSITY ANESTHESIA PROVIDERS
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699711143
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 860213
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55486-0213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-683-5494
Provider Business Mailing Address Fax Number:
412-937-5708

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2450 RIVERSIDE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55454-1400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-273-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RING
Authorized Official First Name:
MAUREEN
Authorized Official Middle Name:
V
Authorized Official Title or Position:
DIRECTOR, NETWORK RELATIONS
Authorized Official Telephone Number:
612-672-6740

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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