Healthcare Provider Details

I. General information

NPI: 1821935933
Provider Name (Legal Business Name): SA MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 2ND AVE S
MINNEAPOLIS MN
55401-5500
US

IV. Provider business mailing address

13288 HUPP CT NE
BLAINE MN
55449
US

V. Phone/Fax

Practice location:
  • Phone: 763-600-2858
  • Fax:
Mailing address:
  • Phone: 763-600-2858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SAUD ANWER
Title or Position: DIRECTOR
Credential:
Phone: 763-600-2858