Active NPI
Midland Prohealth
- Durable Medical Equipment & Medical Supplies
- Fargo, ND
National Provider Identifier
1396774550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- MIDLAND PROHEALTH
- Practice address
- 3003 32ND Ave S
#7
Fargo, ND 58103-6163 - Phone
- (701) 277-1993
- Fax
- (701) 277-3192
- NPI assigned
- Jul 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gerald P Geiger
- Title
- Director
- Phone
- (701) 277-1993
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
3003 32ND Ave S
#7
Fargo, ND 58103-6163
Mailing address
3003 32ND Ave S
#7
Fargo, ND 58103-6163
Phone (701) 277-1993
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9150240 | Medicaid | SD | |
| 39354 | Other | MN | HEALTH PARTNERS |
| 45036 | Other | COMP CARE | |
| 45036MI | Other | CIGNA EMPLOYEE | |
| MHE432581 | Other | PGA PROCARE | |
| 45036MI | Other | MN | BLUE PLUS |
| 45036MI | Other | MN | BCBS |
| 5603806 | Other | MT | MEDICAID |
| 56385 | Medicaid | ND | |
| 7871 | Other | ND | BCBS |
| 76571 | Other | MN | HEALTH PARTNERS |
| 8200344 | Other | MN | MEDICA |
| 70510 | Other | ND | BCBS |
Other names 1
- CostCare Medical Store
National Provider Directory
National Provider Directory- Tax ID family
- Costcare Medical Store
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Grand Forks, ND
- NPI 1235376641
Locations
3003 32nd Ave S
#7
Fargo, ND 58103
Phone (701) 277-1993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1396774550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3003 32ND AVE S",
"address_2": "#7",
"city": "FARGO",
"state": "ND",
"postal_code": "581036163",
"telephone_number": "701-277-1993",
"fax_number": "701-277-3192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3003 32ND AVE S",
"address_2": "#7",
"city": "FARGO",
"state": "ND",
"postal_code": "581036163",
"telephone_number": "701-277-1993",
"fax_number": "701-277-3192"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDLAND PROHEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-01",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GEIGER",
"authorized_official_first_name": "GERALD",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "701-277-1993",
"authorized_official_name_prefix": "Mr."
},
"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": "9150240",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "39354",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMP CARE",
"identifier": "45036",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA EMPLOYEE",
"identifier": "45036MI",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PGA PROCARE",
"identifier": "MHE432581",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE PLUS",
"identifier": "45036MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "45036MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "5603806",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "56385",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "7871",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "76571",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "8200344",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "70510",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CostCare Medical Store",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fargo, ND
- Katelyn Ann Mickelson
- Margaret Traynor Mickelson, MD
- Grace Mickish
- Andrea Jean Middlestead, NP-C
- Ashley Patricia Middleton Peterson, LCSW
- Midwest Drug Distribution Inc
- Midwest Drug Distribution Inc
- Midwest Eye Laboratories Sioux Falls, LLC
- Midwest Hypnosis Clinics/NWCC
- Midwest Medical Equipment & Supplies, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.