| Organization Name: | CENTRAL MINNESOTA SURGICAL CENTER, LLC |
| NPI Number: | 1275762957 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MITCHELL V GOSSMAN (CHIEF MANAGER/MEDICAL DIRECTOR) |
| Mailing Address: | 2000 23rd St S Ste 305 Sartell |
| State: | MN US |
| Postal Code: | 56377 |
| Phone Number: | 3202297955 |
| Fax Number: | 3202297901 |
| NPI Enumeration Date: | 07/02/2009 |
| NPI Last Update Date: | 10/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |