# CORNER MEDICAL LLC

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

## Provider details

- **NPI number:** 1548027055
- **Authorized official:** TAMMI LEE BAGSTAD OHCC, CHCO (COMPLIANCE MANAGER)
- **Authorized official phone:** (763) 540-6119

## Contact information

- **Practice address:** 4350 S WASHINGTON ST STE 104, GRAND FORKS, ND 58201-7184
- **Practice address phone:** (701) 780-2500
- **Practice address fax:** (701) 780-1643
- **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:** 03/01/2024
- **Last updated:** 03/01/2024