Power Chairs and Scooter Store Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC

Practice address

540 Main St S
Pine City, MN 55063

Phone

(320) 629-1149

Fax

(320) 629-1287

NPI assigned

Apr 22, 2013

Organization subpart

No

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

Authorized official

Name

Joel R Erickson

Title

Owner / President

Phone

(651) 982-0002

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Forest Lake Medical Supply Doing business as
• Pine City Medical Supply Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Power Chairs and Scooter Store Medical Supply LLC

  • Customized Equipment (DME)
  • Forest Lake, MN
  • NPI 1447560057

  3173709789

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Power Chairs and Scooter Store Medical Supply LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Power Chairs and Scooter Store Medical Supply LLC

  • Customized Equipment (DME)
  • Forest Lake, MN
  • NPI 1447560057
  NPD tax ID

Locations

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1346684289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MAIN ST S",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550631659",
            "telephone_number": "320-629-1149",
            "fax_number": "320-629-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MAIN ST S",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "55063",
            "telephone_number": "320-629-1149",
            "fax_number": "320-629-1287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "651-982-0002"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447560057",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346684289",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Lake Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Forest Lake Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pine City Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pine City Chiropractic PLLC
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• Michaela Janssen Pohl, MA, LPCC
• Jeffrey Pounds, LP
• Premier Chiropractic LLC
• Umair Rehman, MD
• Janice Reich, LMFT
• Linda M Richnofsky, LMFT
• Ringness Therapy & Consulting LLC

• Durable Medical Equipment & Medical Supplies in Pine City, MN
• Providers in Pine City, 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 Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.