Minnesota Independent Cooperative

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MINNESOTA INDEPENDENT COOPERATIVE

Doing business as

Diabetic Care Inc.

Practice address

2980 Commers Dr Ste 200
Eagan, MN 55121-2370

Phone

(800) 940-1934

NPI assigned

Feb 12, 2013

Last updated

Feb 12, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James Russo

Title

VP of Operations

Phone

(651) 686-5011

Specialties & licenses 2

Addresses

Other names 1

• Diabetic Care Inc. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360627200000",
    "number": "1033458922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 COMMERS DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212370",
            "telephone_number": "800-940-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2980 COMMERS DR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212370",
            "telephone_number": "800-940-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA INDEPENDENT COOPERATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "651-686-5011"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "361687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetic Care Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Eagan, MN
• Providers in Eagan, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.