Organization
POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC
Active
Organization
POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC
Active
Other names
Pine City Medical Supply, Forest Lake Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL R ERICKSON (OWNER / PRESIDENT)
(651) 982-0002
Entity
Organization
Contact information
Practice address
540 MAIN ST S, PINE CITY, MN 55063
(320) 629-1149
(320) 629-1287
Mailing address
540 MAIN ST S, PINE CITY, MN 55063-1659
(320) 629-1149
(320) 629-1287
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346684289
—
MN
05
—
1447560057
—
MN
Enumeration date
04/22/2013
Last updated
10/10/2018
Update your record
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