Provider Demographics
NPI:1831469063
Name:ABSOLUTE MEDICAL & RENOVATIONS INC.
Entity type:Organization
Organization Name:ABSOLUTE MEDICAL & RENOVATIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:TRACY
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-358-3202
Mailing Address - Street 1:48675 ANCHOR AVE
Mailing Address - Street 2:
Mailing Address - City:STANCHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55080-5223
Mailing Address - Country:US
Mailing Address - Phone:320-358-3202
Mailing Address - Fax:320-358-3202
Practice Address - Street 1:48675 ANCHOR AVE
Practice Address - Street 2:
Practice Address - City:STANCHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55080-5223
Practice Address - Country:US
Practice Address - Phone:320-358-3202
Practice Address - Fax:320-358-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment