Organization
CENTRACARE MEDICAL SUPPLY LLC
Active
Parent organization
CENTRACARE MEDICAL SUPPLY LLC
Other names
Rice Home Medical LLC - DME Madison
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRACARE MEDICAL SUPPLY LLC
Authorized official
MICHAEL A BLAIR (SR VP & CFO)
(320) 255-5665
Entity
Organization
Contact information
Practice address
105 6TH AVE, MADISON, MN 56256-1300
(320) 762-6036
Mailing address
1200 6TH AVE N, SAINT CLOUD, MN 56303-2736
(320) 251-2700
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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