MEDICARE: TWIN CITIES MEDICAL SUPPLY

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		MN

General Provider Information

NPI Number	:	1225109093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TWIN CITIES MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	16720 73RD PL N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2130
Country	:	US
Telephone Number	:	763-420-4005
Fax Number	:

Provider Business Practice Location Address
First Line	:	16720 73RD PL N
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-2130
Country	:	US
Telephone Number	:	763-420-4005
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JEREMY BENACKA
Credential	:
Telephone Number	:	763-420-4005

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1447422183 — FRIENDS & FAMILY HOMECARE
Practice Location Address:

16720 73RD PL N
MAPLE GROVE, MN
55311-2130

Practice Phone: 763-420-4005
Practice Fax:

1174001010 — JEREMY BENACKA
Practice Location Address:

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1447189436 — JODI NORDSTROM PHARMD
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1982682407 — MS. SALI HONESS-ONDREY LCSW
Practice Location Address:

2130 S MAPLE AVE
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1245391382 — ROBERT J SHIMBORSKI DDS
Practice Location Address:

123 W MAPLE AVE
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Practice Phone: 215-757-2151
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1124146816 — STEPHEN J LEE D.C.
Practice Location Address:

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Practice Phone: 215-702-3440
Practice Fax: 215-702-3442

Directions to “TWIN CITIES MEDICAL SUPPLY ” Practice Location

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