Provider Demographics
NPI:1689908287
Name:CARING MEDICAL DISTRIBUTORS INC
Entity Type:Organization
Organization Name:CARING MEDICAL DISTRIBUTORS INC
Other - Org Name:PRAIRIE HOME HEALTH CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:KODAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-987-1120
Mailing Address - Street 1:2601 BLOOMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1137
Mailing Address - Country:US
Mailing Address - Phone:612-987-1120
Mailing Address - Fax:612-872-1550
Practice Address - Street 1:2601 BLOOMINGTON AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1137
Practice Address - Country:US
Practice Address - Phone:612-987-1120
Practice Address - Fax:612-872-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN814177903613332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies