Healthcare Provider Details

I. General information

NPI: 1497702583
Provider Name (Legal Business Name): FLAD ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 04/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 WALNUT ST
WINONA MN
55987-3404
US

IV. Provider business mailing address

163 WALNUT ST P O BOX 111
WINONA MN
55987-3404
US

V. Phone/Fax

Practice location:
  • Phone: 507-452-1313
  • Fax: 507-454-5717
Mailing address:
  • Phone: 507-452-1313
  • Fax: 507-454-5717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4598806
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN J FLAD
Title or Position: PRESIDENT
Credential:
Phone: 507-454-1315