Power Chairs and Scooter Store Medical Supply LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC

Practice address

255 Highway 97
7B
Forest Lake, MN 55025-2697

Phone

(651) 982-0002

Fax

(651) 982-0030

NPI assigned

Oct 15, 2010

Organization subpart

No

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

Authorized official

Name

Joel Robert Erickson

Title

Owner

Phone

(651) 982-0002

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Forest Lake 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

  • Durable Medical Equipment & Medical Supplies
  • Pine City, MN
  • NPI 1346684289

  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

  • Durable Medical Equipment & Medical Supplies
  • Pine City, MN
  • NPI 1346684289
  NPD tax ID

Locations

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539993600000",
    "number": "1447560057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HIGHWAY 97",
            "address_2": "7B",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252697",
            "telephone_number": "651-982-0002",
            "fax_number": "651-982-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HIGHWAY 97",
            "address_2": "7B",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252697",
            "telephone_number": "651-982-0002",
            "fax_number": "651-982-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWER CHAIRS AND SCOOTER STORE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2018-10-20",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-982-0002"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447560057",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Lake Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel F Pink, DDS
• Daniel Philip Piper, DC
• Trista Pleski
• Michael Poindexter, M.S.
• Julie Ann Porath, LICSW
• Progress Valley, Inc.
• Leona Claire Pyle, RPH
• Lori Quist, MA, LADC
• Renew Pediatric Therapy LLC
• Nathan Riedeman, PHARMD

• Customized Equipment (DME) in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Customized Equipment (DME) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.