Organization
INTEGRATED DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS MACKEY (OWNER)
(952) 807-5389
Entity
Organization
Contact information
Practice address
2818 EAGLE VALLEY DR, WOODBURY, MN 55129-4263
(952) 807-5389
Mailing address
2818 EAGLE VALLEY DR, WOODBURY, MN 55129-4263
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
3756181-3
MN
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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