Provider Demographics
NPI:1447905187
Name:COWBOY LOGIC LLC
Entity type:Organization
Organization Name:COWBOY LOGIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:SORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-353-7032
Mailing Address - Street 1:2508 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-3567
Mailing Address - Country:US
Mailing Address - Phone:610-868-7333
Mailing Address - Fax:
Practice Address - Street 1:2508 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-3567
Practice Address - Country:US
Practice Address - Phone:610-868-7333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health