| NPI | 1174285423 |
|---|---|
| Doing Business As | LIFESOURCE |
| Entity Type | Organization |
| Authorized Contact | PETER DAVID FARSTAD Chief Administrative Officer 612-800-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335U00000X Organ Procurement Organization |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-10-13 |