Provider Demographics
NPI:1467778977
Name:RMERICKSON FURNITURE
Entity Type:Organization
Organization Name:RMERICKSON FURNITURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-334-4364
Mailing Address - Street 1:30 N.W. 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021-4202
Mailing Address - Country:US
Mailing Address - Phone:507-334-4364
Mailing Address - Fax:
Practice Address - Street 1:30 NW 5TH STREET
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-4202
Practice Address - Country:US
Practice Address - Phone:507-334-4364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies