SAND PINE PHEASANTS FAMILY RECREATION LLC (NPI# 1225675739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225675739 |
| Entity Type | Organization |
| Organization Name | SAND PINE PHEASANTS FAMILY RECREATION LLC |
| Practice Address |
12195 Norway Rd Avon MN 56310-4502 |
| Practice Telephone | 3203634790 |
| Practice Fax Number | 3203634790 |
| Mailing Telephone | 3203634790 |
| Mailing Fax Number | 3203634790 |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |
| Authorized Official Name | MR. KEITH JOSEPH SAND (OWNER) |
| Authorized Official Telephone | 3203634790 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Sand Pine Pheasants Family Recreation LLC | Doing Business As Name - Organization |
| Street Address |
12195 NORWAY RD |
| City | AVON |
| State | MN |
| Zip Code | 56310-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184260705 | Keith Joseph Sand | Durable Medical Equipment & Medical Supplies | 12195 Norway Rd, Avon, MN 56310-4502 | 2019-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922137447 | Avon Dental Clinic Pa | Dentist | 308a Blattner Drive, Avon, MN 56310 | 2007-03-02 |
| 1033482583 | Central Minnesota Alarms, Inc | Emergency Response System Companies | 115 1st Street Ne, Avon, MN 56310-0257 | 2012-02-14 |
| 1710128772 | Regional Health Center of Avon, Inc. | Chiropractor | 300 Avon Ave S, Suite F, Avon, MN 56310-4528 | 2009-03-20 |
| 1932368883 | Regional Health Center of Avon, LLC | Chiropractor | 300 Avon Ave S, Suite F, Avon, MN 56310-4528 | 2008-06-05 |
| 1013277094 | Alyssa Lynn Gullickson | Dentist | 308 Blattner Dr, Suite A, Avon, MN 56310-4531 | 2012-05-23 |
| 1629209226 | Minnesota Orthotics | Durable Medical Equipment & Medical Supplies | 108 Avon Ave N, Avon, MN 56310-8515 | 2009-07-30 |
| 1891785226 | Kathleen M Moen | Dentist | 300 Avon Ave S, Suite F, Avon, MN 56310-8516 | 2005-10-26 |
| 1922365865 | K & S Pharmacy Ltd | Pharmacy | 107 Avon Ave S Ste 1, Avon, MN 56310-8517 | 2012-04-17 |
| 1598776999 | Kathleen Alice Beuning | Nurse Practitioner | 37905 186th Avenue, Avon, MN 56310-8704 | 2006-08-10 |
| 1720176860 | Connie Ann Schultz | Social Worker | 12533 355th St, Avon, MN 56310-8736 | 2006-10-11 |
| Find all providers in zip 56310 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247338 | Alledran Med LLC | Durable Medical Equipment & Medical Supplies | 47 Avonwood Road, Unit #218, Avon, CT 06001 | 2020-08-28 |
| 1225658727 | Andrew J Elbert | Durable Medical Equipment & Medical Supplies | 1049 Center Rd # 12, Avon, OH 44011-1205 | 2020-04-24 |
| 1184260705 | Keith Joseph Sand | Durable Medical Equipment & Medical Supplies | 12195 Norway Rd, Avon, MN 56310-4502 | 2019-11-19 |
| 1750845889 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 1810 Nagel Rd, Avon, OH 44011 | 2019-01-23 |
| 1326397837 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 15 Sun Rd, Avon, CO 81620 | 2012-08-30 |
| 1942570825 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 10841 E Us Highway 36, Avon, IN 46123-7981 | 2012-01-09 |
| 1255655593 | Joseph A. Girgis, Md Inc. | Durable Medical Equipment & Medical Supplies | 37452 Colorado Ave, Avon, OH 44011-1532 | 2010-03-16 |
| 1063569531 | Otto Bock Healthcare Lp | Durable Medical Equipment & Medical Supplies | 910 Nottingham Road, Suite S-4, Avon, CO 81620 | 2007-01-05 |
| 1801969324 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 108 N Avon Ave, Avon, IN 46123-8475 | 2006-11-15 |
| 1114012051 | American Health Network of Indiana, LLC | Durable Medical Equipment & Medical Supplies | 8244 Us 36, Suite 1340, Avon, IN 46123 | 2006-10-04 |
| Find all providers in AVON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.