Provider Demographics
NPI:1952599144
Name:MSS
Entity Type:Organization
Organization Name:MSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ROBLUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-368-4548
Mailing Address - Street 1:5775 W OLD SHAKOPEE RD
Mailing Address - Street 2:SUITE 80
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3173
Mailing Address - Country:US
Mailing Address - Phone:952-881-2500
Mailing Address - Fax:
Practice Address - Street 1:5775 W OLD SHAKOPEE RD
Practice Address - Street 2:SUITE 80
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-3173
Practice Address - Country:US
Practice Address - Phone:952-881-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies