Total Medical Supply Co Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TOTAL MEDICAL SUPPLY CO INC

Practice address

7777 Highway 65 NE
Suite F
Spring Lake Park, MN 55432-2851

Phone

(763) 784-6140

Fax

(763) 780-3151

NPI assigned

Jun 26, 2006

Organization subpart

No

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

Authorized official

Name

Jeremy R Johnson

Title

Delegated Official

Phone

(763) 784-6140

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

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

Locations

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1437186707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HIGHWAY 65 NE",
            "address_2": "SUITE F",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322851",
            "telephone_number": "763-784-6140",
            "fax_number": "763-780-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HIGHWAY 65 NE",
            "address_2": "SUITE F",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322851",
            "telephone_number": "763-784-6140",
            "fax_number": "763-780-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL MEDICAL SUPPLY CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "763-784-6140"
    },
    "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": "720720400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "00820000934",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suite Living Senior Care of Spring Lake Park
• Kelly Summers, LADC
• Heather Elaine Swanson, M.D.
• Brady Harrison Thompson
• Antenalu Desta Tona
• Jean Linda Udesen
• Trevor Velin, DC
• Vibrance Home Care LLC
• Wabo Alf LLC
• Junao Wang, M.D.

• Durable Medical Equipment & Medical Supplies in Spring Lake Park, MN
• Providers in Spring Lake Park, 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 May 2, 2014; 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.