Northmark Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

000828233

Legal business name

NORTHMARK MEDICAL LLC

Doing business as

Northmark Medical

Practice address

1260 Yankee Doodle Rd
# 202
Eagan, MN 55121-2201

Phone

(651) 888-2613

Fax

(651) 846-6777

NPI assigned

Sep 4, 2012

Organization subpart

No

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

Authorized official

Name

D Haglind

Title

Owner

Phone

(651) 888-2613

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Northmark Medical Doing business as

Locations

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1184973356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 YANKEE DOODLE RD",
            "address_2": "# 202",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212201",
            "telephone_number": "651-888-2613",
            "fax_number": "651-846-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 YANKEE DOODLE RD",
            "address_2": "# 202",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212201",
            "telephone_number": "651-888-2613",
            "fax_number": "651-846-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHMARK MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "HAGLIND",
        "authorized_official_first_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-888-2613"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": "000828233",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": "000828233",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEDORTHIST",
            "identifier": "000828233",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northmark Medical",
            "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 Dec 11, 2012; 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.