Provider Demographics
NPI:1821517053
Name:HUMAN CARE MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:HUMAN CARE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDISALAM
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-417-2373
Mailing Address - Street 1:3255 COACHMAN RD APT 239
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55121-2821
Mailing Address - Country:US
Mailing Address - Phone:612-417-2373
Mailing Address - Fax:
Practice Address - Street 1:2910 PILLSBURY AVE S APT 434
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-5504
Practice Address - Country:US
Practice Address - Phone:612-417-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1326579608OtherTRANSPORTATION