Organization
TOTAL MEDICAL SUPPLY CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY R JOHNSON (DELEGATED OFFICIAL)
(763) 784-6140
Entity
Organization
Contact information
Practice address
7777 HIGHWAY 65 NE, SUITE F, SPRING LAKE PARK, MN 55432-2851
(763) 784-6140
(763) 780-3151
Mailing address
7777 HIGHWAY 65 NE, SUITE F, SPRING LAKE PARK, MN 55432-2851
(763) 784-6140
(763) 780-3151
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00820000934
MEDICA
MN
05
—
720720400
—
MN
Enumeration date
06/26/2006
Last updated
05/02/2014
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