Provider Demographics
NPI:1225193899
Name:BARBARA ANN CURRIN
Entity Type:Organization
Organization Name:BARBARA ANN CURRIN
Other - Org Name:OMETTA MEDICAL SUPPLY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CURRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-551-1123
Mailing Address - Street 1:3140 HARBOR LN N
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-5118
Mailing Address - Country:US
Mailing Address - Phone:763-551-1123
Mailing Address - Fax:763-551-1109
Practice Address - Street 1:3140 HARBOR LN N
Practice Address - Street 2:SUITE 250
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5118
Practice Address - Country:US
Practice Address - Phone:763-551-1123
Practice Address - Fax:763-551-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8226075332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5683340001Medicare NSC