Healthcare Provider Details

I. General information

NPI: 1508568536
Provider Name (Legal Business Name): CONSOLIDATED HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 AIR PARK DRIVE
AITKIN MN
56431
US

IV. Provider business mailing address

8400 CORAL SEA STREET NE
MOUNDS VIEW MN
55112
US

V. Phone/Fax

Practice location:
  • Phone: 763-780-0100
  • Fax: 763-780-0420
Mailing address:
  • Phone: 763-780-0100
  • Fax: 763-780-0420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: RICHARD J ZUNKER
Title or Position: OWNER
Credential:
Phone: 763-780-0100