Provider Demographics
NPI:1750418562
Name:EDIMA CORPORATION
Entity type:Organization
Organization Name:EDIMA CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YOMI
Authorized Official - Middle Name:TAOFIK
Authorized Official - Last Name:OKEMATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-219-8381
Mailing Address - Street 1:22800 CLAIRE CT
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4541
Mailing Address - Country:US
Mailing Address - Phone:763-219-8381
Mailing Address - Fax:763-390-6799
Practice Address - Street 1:22800 CLAIRE CT
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4541
Practice Address - Country:US
Practice Address - Phone:763-219-8381
Practice Address - Fax:763-390-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12Q-238332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies