Provider Demographics
NPI:1053645929
Name:CONSUMERS MEDICAL SUPPLY
Entity Type:Organization
Organization Name:CONSUMERS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLEJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-367-4274
Mailing Address - Street 1:619 LAFAYETTE RD N
Mailing Address - Street 2:311
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-4446
Mailing Address - Country:US
Mailing Address - Phone:612-220-1858
Mailing Address - Fax:651-774-2847
Practice Address - Street 1:619 LAFAYETTE RD N
Practice Address - Street 2:311
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-4446
Practice Address - Country:US
Practice Address - Phone:612-220-1858
Practice Address - Fax:651-774-2847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment