Healthcare Provider Details

I. General information

NPI: 1255038105
Provider Name (Legal Business Name): MERCARIK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1391 IOWA AVE W
FALCON HEIGHTS MN
55108-2122
US

IV. Provider business mailing address

1391 IOWA AVE W
FALCON HEIGHTS MN
55108-2122
US

V. Phone/Fax

Practice location:
  • Phone: 651-270-8871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225CA2500X
TaxonomyAssistive Technology Supplier Rehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW HANSEN
Title or Position: OWNER AND CEO
Credential:
Phone: 651-270-8871