MEDICARE: REPLACEMENT RESERVES 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	310400000X	Assisted Living Facility
2	251E00000X	Home Health Agency	339763	MN

General Provider Information

NPI Number	:	1437324324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REPLACEMENT RESERVES LLC

Provider Business Mailing Address
First Line	:	1007 E 14TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 E 14TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-1314
Country	:	US
Telephone Number	:	612-238-5201
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	SEELOCHANI STADTHERR
Credential	:
Telephone Number	:	952-855-5041

Provider Enumeration Date	:	04/23/2008
Last Update Date	:	07/22/2021

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