Healthcare Provider Details

I. General information

NPI: 1659570661
Provider Name (Legal Business Name): CUMMINGS MOBILITY CONVERSIONS & SUPPLY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11238 RIVER RD NE
HANOVER MN
55341-4022
US

IV. Provider business mailing address

11238 RIVER RD NE PO BOX 26
HANOVER MN
55341-4022
US

V. Phone/Fax

Practice location:
  • Phone: 763-498-7887
  • Fax:
Mailing address:
  • Phone: 763-498-7887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateMN

VIII. Authorized Official

Name: LINDA BENSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 763-498-7887