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Organization

CENTRACARE MEDICAL SUPPLY LLC

Active
Other names
Rice Home Medical LLC DME Willmar
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization

Contact information

Practice address
1033 19TH AVE SW, WILLMAR, MN 56201-5005
(320) 235-8434
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2735
(320) 251-2700

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
11/19/2020
Last updated
11/19/2020
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