Provider Demographics
NPI:1932108453
Name:CARE MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:CARE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:TONJA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-251-8261
Mailing Address - Street 1:1000 S BENTON DR
Mailing Address - Street 2:SUITE 418
Mailing Address - City:SAUK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56379-1227
Mailing Address - Country:US
Mailing Address - Phone:320-251-8261
Mailing Address - Fax:320-251-7023
Practice Address - Street 1:1000 S BENTON DR
Practice Address - Street 2:SUITE 418
Practice Address - City:SAUK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56379-1227
Practice Address - Country:US
Practice Address - Phone:320-251-8261
Practice Address - Fax:320-251-7023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
110492OtherUCARE
8200123OtherMEDICA
MN885863200Medicaid
13747CAOtherBLUE CROSS BLUE SHIELD
1010935OtherPREFERREDONE
21482OtherHEALTH PARTNERS
8200123OtherMEDICA