Organization
LAKE SUPERIOR MEDICAL EQUIPMENT INC
Active
Parent organization
LAKE SUPERIOR MEDICAL EQUIPMENT INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAKE SUPERIOR MEDICAL EQUIPMENT INC
Authorized official
LAURIE ANN KING (PRESIDENT)
(218) 727-0600
Entity
Organization
Contact information
Practice address
211 W HWY 61, GRAND MARAIS, MN 55604-1500
(218) 387-1584
(218) 387-1574
Mailing address
211 W HWY 61, PO BOX 1500, GRAND MARAIS, MN 55604-1500
(218) 387-1584
(218) 387-1574
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
361203
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125158900
—
MN
05
—
41725700
—
WI
Enumeration date
05/17/2011
Last updated
05/17/2011
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