Provider Demographics
NPI:1609233543
Name:PROMED, INC.
Entity type:Organization
Organization Name:PROMED, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:THIBODEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-633-6287
Mailing Address - Street 1:27375 VIA INDUSTRIA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3699
Mailing Address - Country:US
Mailing Address - Phone:844-633-6287
Mailing Address - Fax:951-296-6383
Practice Address - Street 1:27375 VIA INDUSTRIA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3699
Practice Address - Country:US
Practice Address - Phone:844-633-6287
Practice Address - Fax:951-296-6383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CADE MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-22
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies