MEDICARE: CORNER MEDICAL LLC

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	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407661853
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORNER MEDICAL LLC

Provider Business Mailing Address
First Line	:	2730 NEVADA AVE N
Second Line	:
City	:	NEW HOPE
State	:	MN
Zip	:	55427-2807
Country	:	US
Telephone Number	:	763-535-5335
Fax Number	:	763-536-3590

Provider Business Practice Location Address
First Line	:	47 E BROADWAY
Second Line	:
City	:	LITTLE FALLS
State	:	MN
Zip	:	56345-3046
Country	:	US
Telephone Number	:	320-412-5650
Fax Number	:	320-635-5298

Authorized Official
Title or Position	:	DIRECTOR OF COMPLIANCE & BILLING
Name	:	SEAN STEINHAUSER
Credential	:
Telephone Number	:	763-535-5335

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	11/03/2025

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Directions to “CORNER MEDICAL LLC ” Practice Location

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