MEDICARE: CENTRACARE MEDICAL SUPPLY 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1598368755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRACARE MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	1200 6TH AVE N
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-2735
Country	:	US
Telephone Number	:	320-251-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 18TH AVE W
Second Line	:
City	:	ALEXANDRIA
State	:	MN
Zip	:	56308-2748
Country	:	US
Telephone Number	:	320-762-6036
Fax Number	:

Authorized Official
Title or Position	:	SR VP & CFO
Name	:	MICHAEL A BLAIR
Credential	:
Telephone Number	:	320-255-5665

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	11/19/2020

Similar Medicare Providers

1003762006 — EL&TG TRANSPORTATION LLC
Practice Location Address:

5831 QUANTRELL AVE APT 309
ALEXANDRIA, VA
22312-2748

Practice Phone: 703-906-9311
Practice Fax:

1669402160 — DR. WILTON A GUILLORY III D.C.
Practice Location Address:

1226 WINDSOR PL
ALEXANDRIA, LA
71303-2748

Practice Phone: 318-487-0960
Practice Fax: 318-487-2002

1831268333 — WILTON A GUILLORY III, DC, LLC
Practice Location Address:

1226 WINDSOR PL
ALEXANDRIA, LA
71303-2748

Practice Phone: 318-487-0960
Practice Fax: 318-487-2002

1376379982 — JAMIE LYNN FELBER RN
Practice Location Address:

410 30TH AVE E
ALEXANDRIA, MN
56308-4769

Practice Phone: 320-255-6339
Practice Fax: 320-759-2023

1114753605 — CINNAMON SHARI LANCASTER
Practice Location Address:

410 30TH AVE E
ALEXANDRIA, MN
56308-4769

Practice Phone: 320-255-6339
Practice Fax: 320-759-2023

1851127658 — JAZMYN ARVIDSON RN
Practice Location Address:

410 30TH AVE E
ALEXANDRIA, MN
56308-4769

Practice Phone: 320-255-6339
Practice Fax:

Directions to “CENTRACARE MEDICAL SUPPLY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.