Provider Demographics
NPI:1619771532
Name:SUPPLYING SENIORS LLC
Entity type:Organization
Organization Name:SUPPLYING SENIORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIKADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDINASIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-687-9827
Mailing Address - Street 1:7121 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-3310
Mailing Address - Country:US
Mailing Address - Phone:952-687-9827
Mailing Address - Fax:
Practice Address - Street 1:7121 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-3310
Practice Address - Country:US
Practice Address - Phone:952-687-9827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty