Provider Demographics
NPI:1609261809
Name:CORNER MEDICAL LLC
Entity Type:Organization
Organization Name:CORNER MEDICAL LLC
Other - Org Name:CORNER HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-388-0500
Mailing Address - Street 1:9720 HUMBOLDT AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2623
Mailing Address - Country:US
Mailing Address - Phone:952-388-0500
Mailing Address - Fax:
Practice Address - Street 1:1270 MOORE LAKE DR E
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-5170
Practice Address - Country:US
Practice Address - Phone:763-502-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33213X2000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies