Chandler Dietrich Enterprices, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

CHANDLER DIETRICH ENTERPRICES, LLC

Practice address

129 Fairlawn Ave E
Winsted, MN 55395-1040

Phone

(612) 384-3049

NPI assigned

Sep 16, 2009

Last updated

Sep 16, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kevin Gerald Dietrich

Title

Owner

Phone

(612) 384-3049

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1578896965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 FAIRLAWN AVE E",
            "city": "WINSTED",
            "state": "MN",
            "postal_code": "553951040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 FAIRLAWN AVE E",
            "city": "WINSTED",
            "state": "MN",
            "postal_code": "553951040",
            "telephone_number": "612-384-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDLER DIETRICH ENTERPRICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "DIETRICH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-384-3049",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Winsted, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.