MEDICARE: D.W.KOSKI,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	2612218	MN
2	3336C0003X	Community/Retail Pharmacy		MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2421460	OTHER	MN	NCPDP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871583898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D.W.KOSKI,INC.

Provider Business Mailing Address
First Line	:	750 MAIN ST
Second Line	:	SUITE 103
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55118-3764
Country	:	US
Telephone Number	:	651-455-6873
Fax Number	:	651-451-7997

Provider Business Practice Location Address
First Line	:	750 MAIN ST
Second Line	:	SUITE 103
City	:	MENDOTA HEIGHTS
State	:	MN
Zip	:	55118-3764
Country	:	US
Telephone Number	:	651-455-6873
Fax Number	:	651-451-7997

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL WILLIAM KOSKI
Credential	:	R.PH.
Telephone Number	:	651-455-6873

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	03/07/2023

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Directions to “D.W.KOSKI,INC. ” Practice Location

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