Organization
MIRACLE CARE DMEPOS
Active
Parent organization
MIRACLE CARE, LLC
Other names
Miracle Care Services, Miracle Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIRACLE CARE, LLC
Authorized official
JATTY D. ZONDO (CEO)
(612) 688-7661
Entity
Organization
Contact information
Practice address
204 JEFFERSON ST N, WADENA, MN 56482-1371
(612) 688-7661
(612) 688-7672
Mailing address
204 JEFFERSON ST N, WADENA, MN 56482-1371
(612) 688-7661
(612) 688-7672
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
06/29/2023
Last updated
10/14/2023
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