Healthcare Provider Details

I. General information

NPI: 1790663466
Provider Name (Legal Business Name): MESABI MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7763 S BIRCH RIDGE RD
BRITT MN
55710-8272
US

IV. Provider business mailing address

7763 S BIRCH RIDGE RD
BRITT MN
55710-8272
US

V. Phone/Fax

Practice location:
  • Phone: 218-750-9308
  • Fax:
Mailing address:
  • Phone: 218-750-9308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DERRICK JON KINNEY
Title or Position: OWNER
Credential:
Phone: 218-750-9308