Idimo Medical Supply
NPI #1790714566 in New Brighton, Minnesota
Provider Information
- NPI Number
- 1790714566
- Entity Type
- Organization
- Organization Name
- Idimo Medical Supply
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jul 2, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 151 SILVER LAKE RD NW
- Address 2
- SUITE 1B
- City
- New Brighton
- State
- Minnesota
- ZIP Code
- 55112-3162
- Phone
- (651) 639-1400
Authorized Official
- Name
- MR. STEPHEN IDEM ETUKO
- Title
- DIRECTOR
- Phone
- (651) 639-1400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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