Organization
NORTHMARK MEDICAL LLC
Active
Other names
Northmark Medical
Organization subpart
No
Provider details
NPI number
Authorized official
D HAGLIND (OWNER)
(651) 888-2613
Entity
Organization
Contact information
Practice address
1260 YANKEE DOODLE RD, # 202, EAGAN, MN 55121-2201
(651) 888-2613
(651) 846-6777
Mailing address
1260 YANKEE DOODLE RD, # 202, EAGAN, MN 55121-2201
(651) 888-2613
(651) 846-6777
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000828233
—
335E00000X
Prosthetic/Orthotic Supplier
000828233
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000828233
PEDORTHIST
—
Enumeration date
09/04/2012
Last updated
12/11/2012
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