Organization
SUBURBAN MEDICAL EQUIPMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL C MADSEN (PRESIDENT)
(763) 274-2299
Entity
Organization
Contact information
Practice address
637 W MAIN ST, ANOKA, MN 55303-1623
(763) 274-2299
(866) 460-2892
Mailing address
637 W MAIN ST, ANOKA, MN 55303-1623
(763) 274-2299
(866) 460-2892
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6480820001
MEDICARE-PTAN
MN
05
—
877376900
—
MN
Enumeration date
10/04/2010
Last updated
09/04/2014
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