# CORNER MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Corner Home Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396442745
- **Authorized official:** TAMMI LEE BAGSTAD (COMPLIANCE OFFICER)
- **Authorized official phone:** (763) 540-6119

## Contact information

- **Practice address:** 1267 S POKEGAMA AVE STE 7, GRAND RAPIDS, MN 55744-4208
- **Practice address phone:** (800) 777-8390
- **Mailing address:** 2730 NEVADA AVE N, NEW HOPE, MN 55427-2807
- **Mailing address phone:** (763) 535-5335

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2023
- **Last updated:** 02/15/2023