Organization
CHILDREN'S MINNESOTA HOME MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA LU ALEXANDER MCCORMICK (SVP AND CFO)
(612) 813-6129
Entity
Organization
Contact information
Practice address
2545 CHICAGO AVE STE 120, MINNEAPOLIS, MN 55404-4541
(612) 813-7220
Mailing address
5901 LINCOLN DRIVE, CBC-2-REV/PE, EDINA, MN 55436-1611
(952) 992-5691
(952) 992-6917
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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