Provider Demographics
NPI:1285965053
Name:CORNER MEDICAL LLC
Entity type:Organization
Organization Name:CORNER MEDICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-535-5335
Mailing Address - Street 1:36 17TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0327
Mailing Address - Country:US
Mailing Address - Phone:507-208-4350
Mailing Address - Fax:507-208-4236
Practice Address - Street 1:36 17TH AVE NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0327
Practice Address - Country:US
Practice Address - Phone:507-208-4350
Practice Address - Fax:507-208-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN361419332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies