Provider Demographics
NPI:1427471911
Name:NORTHWOODS SURGERY CENTER LLC
Entity type:Organization
Organization Name:NORTHWOODS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-471-1220
Mailing Address - Street 1:502 N 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-2336
Mailing Address - Country:US
Mailing Address - Phone:218-471-1220
Mailing Address - Fax:218-471-1230
Practice Address - Street 1:502 N 6TH AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2336
Practice Address - Country:US
Practice Address - Phone:218-471-1220
Practice Address - Fax:218-471-1230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1427471911OtherHEALTHPARTNERS
MN1427471911OtherMEDICA
MN1427471911OtherUCARE
MN1427471911Medicaid
MN1427471911OtherBLUE CROSS BLUE SHIELD
MN1427471911OtherBLUE CROSS BLUE SHIELD
MN1427471911OtherHEALTHPARTNERS