Organization
AT HOME MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNDA KRALL (OWNER)
(507) 453-9300
Entity
Organization
Contact information
Practice address
1152 GILMORE AVE, WINONA, MN 55987-2404
(507) 453-9300
Mailing address
1152 GILMORE AVE, WINONA, MN 55987-2404
(507) 453-9300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2324445
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105861
CLEAR CONNECT
MN
01
—
41693800
WISCONSIN MEDICAID
MN
01
—
63375
HEALTH PARTNERS
MN
01
—
6G749AT
BCBS
MN
01
—
723336
PREFFERED ONE
MN
Enumeration date
11/01/2006
Last updated
08/22/2020
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