Basic Information
| Provider Information | |||||||||
| NPI: | 1568606655 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PINDROP HEARING OF SOUTHERN MINNESOTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14750 CEDAR AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | APPLE VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551244506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528911191 | ||||||||
| FaxNumber: | 9528911192 | ||||||||
| Practice Location | |||||||||
| Address1: | 14750 CEDAR AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | APPLE VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551244506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9528911191 | ||||||||
| FaxNumber: | 9528911192 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2009 | ||||||||
| LastUpdateDate: | 04/21/2009 | ||||||||
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| AuthorizedOfficialLastName: | ERICKSON | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9528911191 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BC-HIS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332S00000X | 2379 | MN | Y | Suppliers | Hearing Aid Equipment |
No ID Information.