Organization
BRAINERD MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN WIEWEL (PRESIDENT)
(218) 829-2100
Entity
Organization
Contact information
Practice address
206 W WASHINGTON ST, BRAINERD, MN 56401-2922
(218) 829-2100
(218) 829-8943
Mailing address
206 W WASHINGTON ST, BRAINERD, MN 56401-2922
(218) 829-2100
(218) 829-8943
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
4598796
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120979
UCARE
MN
01
—
81238BR
BLUE CROSS BLUE SHIELD
MN
01
—
8214066
MEDICA
MN
Enumeration date
07/15/2006
Last updated
08/22/2020
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