Provider Demographics
NPI:1679554067
Name:ANDERSON'S WHEELCHAIR INC.
Entity Type:Organization
Organization Name:ANDERSON'S WHEELCHAIR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-288-0113
Mailing Address - Street 1:1117 2ND ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-1936
Mailing Address - Country:US
Mailing Address - Phone:507-288-0113
Mailing Address - Fax:507-288-0414
Practice Address - Street 1:1117 2ND ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-1936
Practice Address - Country:US
Practice Address - Phone:507-288-0113
Practice Address - Fax:507-288-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN359562500Medicaid
MN0221040001Medicare NSC