Provider Demographics
NPI:1447085238
Name:INSTRUMENT SERVICE AND REPAIR LLC
Entity type:Organization
Organization Name:INSTRUMENT SERVICE AND REPAIR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-438-0100
Mailing Address - Street 1:8217 HOLLOPETER RD
Mailing Address - Street 2:
Mailing Address - City:LEO
Mailing Address - State:IN
Mailing Address - Zip Code:46765-9262
Mailing Address - Country:US
Mailing Address - Phone:517-438-0100
Mailing Address - Fax:
Practice Address - Street 1:8217 HOLLOPETER RD
Practice Address - Street 2:
Practice Address - City:LEO
Practice Address - State:IN
Practice Address - Zip Code:46765-9262
Practice Address - Country:US
Practice Address - Phone:517-438-0100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies