MEDICARE: MEDICAL EQUIPMENT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1043539125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL EQUIPMENT SERVICES LLC

Provider Business Mailing Address
First Line	:	2119 ELLIOT AVE UNIT 1
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2971
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 ELLIOT AVE UNIT 1
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2971
Country	:	US
Telephone Number	:	612-384-6002
Fax Number	:

Authorized Official
Title or Position	:	CO OWNER
Name	:	ABDIRAHMAN HASSAN
Credential	:
Telephone Number	:	612-384-6002

Provider Enumeration Date	:	05/27/2010
Last Update Date	:	05/27/2010

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