Organization
DME REPAIR SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD ALLEN ELIAS (OWNER)
(507) 926-5968
Entity
Organization
Contact information
Practice address
23647 140TH ST, WILMONT, MN 56185-1083
(507) 926-5968
(507) 926-5399
Mailing address
23647 140TH ST, WILMONT, MN 56185-1083
(507) 926-5968
(507) 926-5399
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8G954DM
BC/BS
MN
Enumeration date
02/06/2008
Last updated
02/06/2008
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