Provider Demographics
NPI:1821151473
Name:RESTWELLL MATTRESS COMPANY
Entity Type:Organization
Organization Name:RESTWELLL MATTRESS COMPANY
Other - Org Name:RESTWELL MATTRESS FACTORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-920-7860
Mailing Address - Street 1:8229 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3904
Mailing Address - Country:US
Mailing Address - Phone:952-908-3348
Mailing Address - Fax:952-908-3346
Practice Address - Street 1:8229 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3904
Practice Address - Country:US
Practice Address - Phone:952-908-3348
Practice Address - Fax:952-920-3466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RESTWELL MATTRESS FACTORY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-18
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5783260002Medicare NSC