PROVAX LLC
NPI 1619202934
Clinic/Center - Community Health in Chanhassen, MN

Q: What is Provax LLC's NPI number?

The NPI number for Provax LLC is 1619202934. It was assigned to this organization in the NPPES registry on October 5, 2009.

Q: What is Provax LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

Q: When was this NPI record last updated?

The NPPES record for Provax LLC was last updated on October 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 05, 2009

2018 STONE CREEK DR, CHANHASSEN, MN 55317(952) 470-6005 Get Directions Write a Review

NPPES record last updated: October 5, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Provax Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVAX LLC (NPI 1619202934) is a healthcare organization registered as a community health in Chanhassen, Minnesota and active in the NPI registry since October 2009. The organization lists Cindy L Egelston, Owner, as its authorized official.

NPPES Registry Identity

NPI1619202934

Entity TypeOrganization

Primary Taxonomy261QC1500X

Legal Business NamePROVAX LLC

Location Address2018 STONE CREEK DRChanhassen, MN 55317-7410

Mailing Address2018 Stone Creek DrChanhassen, MN 55317-7410 · (952) 470-6005

Phone(952) 470-6005

Organization SubpartNo

Authorized OfficialCindy L EgelstonOwner · (952) 470-6005

Enumeration DateOctober 5, 2009

✔ NPI 1619202934 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Community HealthAmbulatory Health Care Facilities

Taxonomy Code261QC1500X

License✔ Licensed in MN · R106374-5

2018 STONE CREEK DR, Chanhassen, MN 55317

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CINDY LOU EGELSTON REGISTERED NURSE

Registered Nurse (Community Health)

2018 STONE CREEK DR
CHANHASSEN, MN 55317

Carver County (952) 470-6005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provax LLC's NPI number?

The NPI number for Provax LLC is 1619202934. It was assigned to this organization in the NPPES registry on October 5, 2009.

Where is Provax LLC located?

Provax LLC is located at 2018 Stone Creek Dr, Chanhassen, MN 55317. The listed phone number is (952) 470-6005.

What is Provax LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Community Health, with taxonomy code 261QC1500X.

When was this NPI record last updated?

The NPPES record for Provax LLC was last updated on October 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.