Provider Demographics
NPI:1851663371
Name:NORTHERN SAFETY & SECURITY LLC
Entity Type:Organization
Organization Name:NORTHERN SAFETY & SECURITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-444-2540
Mailing Address - Street 1:4111 TECHNOLOGY DR NW
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4111 TECHNOLOGY DR NW
Practice Address - Street 2:SUITE 203
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5128
Practice Address - Country:US
Practice Address - Phone:218-444-3902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNTS00444332B00000X, 333300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA734422800OtherMINNESOTA PROVIDER IDENTIFICATION