Organization
MIDWEST MEDICAL EQUIPMENT & SUPPLIES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BOREN (CFO)
(218) 786-1009
Entity
Organization
Contact information
Practice address
530 E 2ND ST, DULUTH, MN 55805-1913
(218) 786-4368
(218) 722-9988
Mailing address
530 E 2ND ST, DULUTH, MN 55805-1913
(218) 786-4368
(218) 722-9988
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32820MI
BLUE CROSS BLUE SHIELD MN
MN
05
—
41660400
—
WI
01
—
8214390
MEDICA COMMERCIAL INSURAN
MN
Enumeration date
10/23/2006
Last updated
11/01/2022
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