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Organization

POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC

Active
Other names
Forest Lake Medical Supply
Organization subpart
No

Provider details

NPI number
Authorized official
JOEL ROBERT ERICKSON (OWNER)
(651) 982-0002
Entity
Organization

Contact information

Practice address
255 HIGHWAY 97, 7B, FOREST LAKE, MN 55025-2697
(651) 982-0002
(651) 982-0030
Mailing address
255 HIGHWAY 97, 7B, FOREST LAKE, MN 55025-2697
(651) 982-0002
(651) 982-0030

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447560057
MN
Enumeration date
10/15/2010
Last updated
10/20/2018
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