MEDICARE: EDINA MEDICAL SUPPLIES, 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		MN

General Provider Information

NPI Number	:	1376530931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDINA MEDICAL SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	6545 FRANCE AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-2131
Country	:	US
Telephone Number	:	952-922-2535
Fax Number	:	952-922-8445

Provider Business Practice Location Address
First Line	:	6545 FRANCE AVE S
Second Line	:
City	:	EDINA
State	:	MN
Zip	:	55435-2131
Country	:	US
Telephone Number	:	952-922-2535
Fax Number	:	952-922-8445

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ERIK SOSUNOV
Credential	:
Telephone Number	:	952-922-2535

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1578569042 — PAUL S. GOTLIEB M.D.
Practice Location Address:

6545 FRANCE AVE S , SUITE 150
EDINA, MN
55435-2131

Practice Phone: 952-848-5600
Practice Fax: 952-848-5556

1437155678 — PRAVEENA M KANTH M.D.
Practice Location Address:

6545 FRANCE AVE S , SUITE 150
EDINA, MN
55435-2131

Practice Phone: 952-848-5600
Practice Fax: 952-848-5573

1396743670 — DR. KEVIN A OCONNOR M.D.
Practice Location Address:

6545 FRANCE AVE S , #671
EDINA, MN
55435-2131

Practice Phone: 952-829-1853
Practice Fax: 952-922-5047

1497741219 — DR. LORA JEAN PRINC M.D.
Practice Location Address:

6545 FRANCE AVE S , SUITE 540
EDINA, MN
55435-2131

Practice Phone: 952-927-4045
Practice Fax: 952-927-0867

1871576116 — OBSTETRICS AND GYNECOLOGY ASSOCIATES, P.A.
Practice Location Address:

6545 FRANCE AVE S , SUITE 600
EDINA, MN
55435-2131

Practice Phone: 952-920-2200
Practice Fax: 952-920-0866

1912980319 — DAWN MARIE BOWKER RN, CNP
Practice Location Address:

6545 FRANCE AVE S , SUITE 600
EDINA, MN
55435-2131

Practice Phone: 952-920-2200
Practice Fax: 952-920-0866

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