Provider Demographics
NPI:1740544378
Name:KRATOS WELLNESS PRODUCTS AND SERVICES
Entity type:Organization
Organization Name:KRATOS WELLNESS PRODUCTS AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:TROGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-250-0956
Mailing Address - Street 1:2270 JADE PL NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-5418
Mailing Address - Country:US
Mailing Address - Phone:507-250-0956
Mailing Address - Fax:
Practice Address - Street 1:2270 JADE PL NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-5418
Practice Address - Country:US
Practice Address - Phone:507-250-0956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies