Provider Demographics
NPI:1982230025
Name:PATRON SUPPLY COMPANIES
Entity Type:Organization
Organization Name:PATRON SUPPLY COMPANIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WARNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-371-6956
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-0399
Mailing Address - Country:US
Mailing Address - Phone:218-371-6956
Mailing Address - Fax:320-287-7019
Practice Address - Street 1:2429 TIFFANY CT
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-7318
Practice Address - Country:US
Practice Address - Phone:320-345-5739
Practice Address - Fax:320-287-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-20
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies