Provider Demographics
NPI:1487030045
Name:ECUMEN
Entity Type:Organization
Organization Name:ECUMEN
Other - Org Name:THE ECUMEN STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/SR VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-766-4300
Mailing Address - Street 1:718 MOUND AVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-1626
Mailing Address - Country:US
Mailing Address - Phone:507-385-4317
Mailing Address - Fax:507-385-8584
Practice Address - Street 1:718 MOUND AVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-1626
Practice Address - Country:US
Practice Address - Phone:507-385-8582
Practice Address - Fax:507-385-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies