NPIMap

Organization Active NPI

Centracare Medical Supply LLC

Doing business as Rice Home Medical LLC - DME Madison

  • Durable Medical Equipment & Medical Supplies
  • Madison, MN
National Provider Identifier
1831792993
Registry record updated Nov 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CENTRACARE MEDICAL SUPPLY LLC
Doing business as
Rice Home Medical LLC - DME Madison
Practice address
105 6TH Ave
Madison, MN 56256-1300
Phone
(320) 762-6036
NPI assigned
Nov 19, 2020
Last updated
Nov 19, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRACARE MEDICAL SUPPLY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2020

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

Authorized official

Name
Michael A Blair
Title
Sr VP & Cfo
Phone
(320) 255-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

105 6TH Ave
Madison, MN 56256-1300

Mailing address

1200 6TH Ave N
Saint Cloud, MN 56303-2736
Phone (320) 251-2700

Other names 1

  • Rice Home Medical LLC - DME Madison Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Centracare Medical Supply LLC4 organizations share this tax ID, including this one
Part of
Centracare Medical Supply LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105 6th Ave
Madison, MN 56256
Phone (320) 598-7303

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605744000000",
    "number": "1831792993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 6TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032736",
            "telephone_number": "320-251-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 6TH AVE",
            "city": "MADISON",
            "state": "MN",
            "postal_code": "562561300",
            "telephone_number": "320-762-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRACARE MEDICAL SUPPLY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRACARE MEDICAL SUPPLY LLC",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR VP & CFO",
        "authorized_official_telephone_number": "320-255-5665"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rice Home Medical LLC - DME Madison",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.