=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750564027
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARKRAY USA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/10/2007
-----------------------------------------------------
Last Update Date | 12/10/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5198 W 76TH ST
-----------------------------------------------------
City | EDINA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55439-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-646-3200
-----------------------------------------------------
Fax | 952-646-3210
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5198 W 76TH ST
-----------------------------------------------------
City | EDINA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55439-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 952-646-3200
-----------------------------------------------------
Fax | 952-646-3210
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGED CARE SALES MANAGER
-----------------------------------------------------
Name | MR. PAUL YAKAPOVICH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 800-566-8558
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 86-777-3280
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------