Elk River Eye Clinic, P.A.

LBN: Elk River Eye Clinic, P.A.
Elk River Eye Clinic, P.A. is an health care organization with primary practice located at 19022 Freeport Ave Nw Suite H, Elk River MN 55330-4767. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optician. Eye and Vision Services Providers / Optometrist is the primary health care specialty. Elk River Eye Clinic, P.A. can be contacted via phone (763) 441-1055, or through Hoffard, Gary Mark via phone (763) 441-1055.

Contact Information

Primary practice address
19022 Freeport Ave Nw Suite H Elk River MN 55330-4767
Phone: (763) 441-1055
Fax: (763) 441-7024
Website:
Map and Directions
Authorized official contact:
Name: Hoffard, Gary Mark Doctor of Optometry (OD)
Phone: (763) 441-1055

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X
Eye and Vision Services Providers / Optician 156FX1800X

Profile Details

NPI number 1063457943
LBN Legal business name Elk River Eye Clinic, P.A.
DBA Doing business as
Authorized official Hoffard, Gary Mark Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 17th, 2006
Last updated Aug 6th, 2010 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063457943 NPPES
Minnesota Other 98-22038 MEDICA CLINIC NUMBER
Minnesota Other 115815 MEDICA CLINIC NUMBER
Minnesota Other 52390HO MEDICA CLINIC NUMBER
Minnesota MEDICAID 379314100 MEDICA CLINIC NUMBER
Minnesota Other 81961 MEDICA CLINIC NUMBER
Minnesota Other 96458 MEDICA CLINIC NUMBER
Minnesota Other 5C159EL MEDICA CLINIC NUMBER
Minnesota Other CJ6982 MEDICA CLINIC NUMBER
Minnesota Other 21-15856 MEDICA CLINIC NUMBER

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