Provider Demographics
NPI:1831259613
Name:HOPE MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:HOPE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:KREMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-388-6820
Mailing Address - Street 1:404 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5225
Mailing Address - Country:US
Mailing Address - Phone:507-388-6820
Mailing Address - Fax:507-388-3611
Practice Address - Street 1:404 HOPE ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5225
Practice Address - Country:US
Practice Address - Phone:507-388-6820
Practice Address - Fax:507-388-3611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3206560332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8G686HOOtherBCBS OF MN
MN1172890001Medicare ID - Type Unspecified