Provena Imaging Services Inc in St Louis Park - Diagnostic Radiology
Provena Imaging Services Inc - NPI 1720197601
Provena Imaging Services Inc is a Diagnostic Radiology in St Louis Park, Minnesota. Provena Imaging Services Inc practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for Provena Imaging Services Inc is 1720197601. The last update date is 2020-08-22.
Provena Imaging Services Inc's current location address is 5775 Wayzata Blvd, St Louis Park, Minnesota. You can contact this provider via phone number 9525428553 and fax number 9525136880. The mailing address for Provena Imaging Services Inc is 5775 Wayzata Blvd, St Louis Park, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Provena Imaging Services Inc |
|---|---|
| Address | 5775 Wayzata Blvd, St Louis Park, Minnesota |
| Phone Number | 9525428553 |
| Fax Number | 9525136880 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Molare Edward |
| Telephone Number | 8158062309 |
NPI Number Detail
| NPI Number | 1720197601 |
|---|---|
| Provider Enumeration Date | 2006-08-30 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 5775 Wayzata Blvd |
|---|---|
| City | St Louis Park |
| State | Minnesota (MN) |
| Post Code | 55416 |
| Phone Number | 9525428553 |
| Fax Number | 9525136880 |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
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What is the unique provider identifier assigned to Provena Imaging Services Inc?
The Provena Imaging Services Inc has been issued the NPI (National Provider Identifier) 1720197601 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Can you provide the Provena Imaging Services Inc's physical address?
The Provena Imaging Services Inc is physically located at 5775 Wayzata Blvd, in the city of St Louis Park, MN, with the postal code 55416.
What is the area of specialization for Provena Imaging Services Inc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Provena Imaging Services Inc is Diagnostic Radiology, and the corresponding taxonomy code that categorizes this area of expertise is 2085R0202X.
On what date was the 1720197601 assigned to Provena Imaging Services Inc?
The Provena Imaging Services Inc was issued its 1720197601 on 2006-08-30, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Provena Imaging Services Inc most recently updated or revised?
The information pertaining to Provena Imaging Services Inc, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.
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