Assisted Living Store, Incorporated

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

4604156 Issued in MN

Legal business name

ASSISTED LIVING STORE, INCORPORATED

Practice address

7687 Hyde Ave S
Cottage Grove, MN 55016-1978

Phone

(651) 769-1574

Fax

(651) 768-7575

NPI assigned

Apr 16, 2008

Last updated

Apr 16, 2008By 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

Mrs. Kimberly Ann Carlson

Title

President

Phone

(651) 769-1574

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1629242102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7687 HYDE AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550161978",
            "telephone_number": "651-769-1574",
            "fax_number": "651-768-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7687 HYDE AVE S",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550161978",
            "telephone_number": "651-769-1574",
            "fax_number": "651-768-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSISTED LIVING STORE, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-769-1574",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MN",
            "license": "4604156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Kathleen Amundson, DDS
• Tanya Marie Anderson, CCC-SLP
• Hillary Marie Andrews
• Craig Lyman Anshus, D.C.
• Martha Name Asare-Dokyi
• Albert Aboudem Atemkeng, LGSW, LICSW
• Sara August, MD
• Avalon Programs LLC (Avalon - Cottage Grove)
• Avanti Medical Group of Minnesota LLC
• Aztec Enitites, LLC (Lifesounds Hearing Healthcare)

• Durable Medical Equipment & Medical Supplies in Cottage Grove, MN
• Providers in Cottage Grove, 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 Apr 16, 2008; 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.