Provider Demographics
NPI:1659456457
Name:KEY MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:KEY MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:3RD PARTY CONTRACTS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:STRODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-792-3860
Mailing Address - Street 1:532 APOLLO DR
Mailing Address - Street 2:SUITE 10
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-3031
Mailing Address - Country:US
Mailing Address - Phone:651-792-3860
Mailing Address - Fax:651-203-0210
Practice Address - Street 1:532 APOLLO DR
Practice Address - Street 2:SUITE 10
Practice Address - City:LINO LAKES
Practice Address - State:MN
Practice Address - Zip Code:55014-3031
Practice Address - Country:US
Practice Address - Phone:651-792-3860
Practice Address - Fax:651-203-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN87726OtherUNITED HEALTH CARE
MN129734OtherUCARE
MN72869OtherHEALTH PARTNERS
MN12D54KEOtherBLUE CROSS BLUE SHIELD
MN8214599OtherMEDICA
MN=========OtherMAYO MANAGEMENT
MN12D54KEOtherBLUE CROSS BLUE SHIELD
MN8214599OtherMEDICA