Organization Name: | POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY |
NPI Number: | 1447560057 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHEN M HARRIS (OWNER) |
Mailing Address: | 255 Highway 97 7b Forest Lake |
State: | MN US |
Postal Code: | 550252697 |
Phone Number: | 6519820002 |
Fax Number: | 6519820030 |
NPI Enumeration Date: | 10/15/2010 |
NPI Last Update Date: | 06/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |