MEDICARE: ADVANCED FIRST-AID, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1033217393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED FIRST-AID, INC

Provider Business Mailing Address
First Line	:	13260 MARIGOLD ST NW
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55448-1090
Country	:	US
Telephone Number	:	612-325-3465
Fax Number	:	763-427-4838

Provider Business Practice Location Address
First Line	:	13260 MARIGOLD ST NW
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55448-1090
Country	:	US
Telephone Number	:	612-325-3465
Fax Number	:	763-427-4838

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MR. PAUL CARLOS MENDOZA
Credential	:	PARAMEDIC
Telephone Number	:	612-325-3465

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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