Healthcare Provider Details

I. General information

NPI: 1013185396
Provider Name (Legal Business Name): AMERICARE MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 WEST ST. GERMAIN ST. SUITE #307
ST. CLOUD MN
56301
US

IV. Provider business mailing address

501 WEST ST. GERMAIN ST. SUITE #307
ST. CLOUD MN
56301
US

V. Phone/Fax

Practice location:
  • Phone: 320-252-2131
  • Fax: 320-230-1290
Mailing address:
  • Phone: 320-252-2131
  • Fax: 320-230-1290

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: MR. JAMES ROBERT NEWMAN
Title or Position: OWNER/PARTNER
Credential:
Phone: 320-252-2131