Provider Demographics
NPI:1417252677
Name:IN MOTION MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:IN MOTION MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NILSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-750-4373
Mailing Address - Street 1:13301 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-3881
Mailing Address - Country:US
Mailing Address - Phone:612-750-4373
Mailing Address - Fax:
Practice Address - Street 1:13301 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-3881
Practice Address - Country:US
Practice Address - Phone:612-750-4373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies