Provider Demographics
NPI:1740375849
Name:PAL MEDICAL SYSTEMS INC
Entity type:Organization
Organization Name:PAL MEDICAL SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:GILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-326-9299
Mailing Address - Street 1:508 SE 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-3921
Mailing Address - Country:US
Mailing Address - Phone:218-326-9299
Mailing Address - Fax:218-326-8306
Practice Address - Street 1:508 SE 10TH ST
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-3921
Practice Address - Country:US
Practice Address - Phone:218-326-9299
Practice Address - Fax:218-326-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI82745700Medicaid
MN30B98PAOtherBLUE CROSS BLUE SHIELD
MN496016500Medicaid
MN060223002OtherPRIME WEST
MN8250355OtherMEDICA