Provider Demographics
NPI:1235292905
Name:GREAT NORTHERN HEALTH PRODUCTS CO
Entity Type:Organization
Organization Name:GREAT NORTHERN HEALTH PRODUCTS CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-432-2138
Mailing Address - Street 1:1320 SUMMIT OAKS DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4715
Mailing Address - Country:US
Mailing Address - Phone:952-432-2138
Mailing Address - Fax:952-891-8658
Practice Address - Street 1:14581 GRAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-5714
Practice Address - Country:US
Practice Address - Phone:952-432-2138
Practice Address - Fax:952-891-8658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1115500001Medicare ID - Type Unspecified