Provider Demographics
NPI:1417088592
Name:MIDWEST REHABILITATION SUPPLY, LLC
Entity Type:Organization
Organization Name:MIDWEST REHABILITATION SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:DINGMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-493-0949
Mailing Address - Street 1:8598 GATEWATER DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-4557
Mailing Address - Country:US
Mailing Address - Phone:320-493-0949
Mailing Address - Fax:
Practice Address - Street 1:8598 GATEWATER DR
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-4557
Practice Address - Country:US
Practice Address - Phone:320-493-0949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies