1689680357 NPI number — MEDICAL EQUIPMENT INC.

Table of content: (NPI 1689680357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689680357 NPI number — MEDICAL EQUIPMENT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL EQUIPMENT INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689680357
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4920 MOUNDVIEW DR
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
RED WING
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55066-1100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-385-5797
Provider Business Mailing Address Fax Number:
651-388-2227

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4920 MOUNDVIEW DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
RED WING
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55066-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-385-5797
Provider Business Practice Location Address Fax Number:
651-388-2227
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STAATS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
651-385-5797

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 041765300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1025956 . This is a "PREFFERED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 41697100 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3G726HI . This is a "BCBSMN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 78544 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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