Provider Demographics
NPI:1447694047
Name:NATIONAL DURABLE MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:NATIONAL DURABLE MEDICAL EQUIPMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COTTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-644-1968
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-9998
Mailing Address - Country:US
Mailing Address - Phone:800-644-1968
Mailing Address - Fax:801-566-3782
Practice Address - Street 1:2123 S. PRIEST DRIVE SUITE 210
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-1104
Practice Address - Country:US
Practice Address - Phone:800-644-1968
Practice Address - Fax:801-566-3782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies