Organization
PREMIUM MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT JOHN FRAHM (OWNER)
(320) 257-0066
Entity
Organization
Contact information
Practice address
26 6TH AVE N, SUITE 370, SAINT CLOUD, MN 56303-4558
(320) 257-0066
(320) 257-0099
Mailing address
26 6TH AVE N, SUITE 370, SAINT CLOUD, MN 56303-4558
(320) 257-0066
(320) 257-0099
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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