Provider Demographics
NPI:1558649913
Name:KRAINA SUPPLIES
Entity Type:Organization
Organization Name:KRAINA SUPPLIES
Other - Org Name:KRAINA SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:HIJAH
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-251-1619
Mailing Address - Street 1:5606 SUMTER AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3312
Mailing Address - Country:US
Mailing Address - Phone:612-521-1619
Mailing Address - Fax:763-219-8482
Practice Address - Street 1:5606 SUMTER AVE N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55428-3312
Practice Address - Country:US
Practice Address - Phone:612-521-1619
Practice Address - Fax:763-219-8482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment