Provider Demographics
NPI:1629005095
Name:NORTHWIND MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:NORTHWIND MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-334-0212
Mailing Address - Street 1:24 DONNA DR
Mailing Address - Street 2:
Mailing Address - City:APOLLO
Mailing Address - State:PA
Mailing Address - Zip Code:15613-9678
Mailing Address - Country:US
Mailing Address - Phone:724-334-0212
Mailing Address - Fax:724-334-0214
Practice Address - Street 1:24 DONNA DR
Practice Address - Street 2:
Practice Address - City:APOLLO
Practice Address - State:PA
Practice Address - Zip Code:15613-9678
Practice Address - Country:US
Practice Address - Phone:724-334-0212
Practice Address - Fax:724-334-0214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5735150001Medicare NSC