Provider Demographics
NPI:1871191643
Name:CRANIAL TECHNOLOGIES, INC.
Entity type:Organization
Organization Name:CRANIAL TECHNOLOGIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATIONAL FACILITIES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-403-6330
Mailing Address - Street 1:1405 W AUTO DR FL 2
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1016
Mailing Address - Country:US
Mailing Address - Phone:480-403-6300
Mailing Address - Fax:844-447-5895
Practice Address - Street 1:2020 W STATE HIGHWAY 114 STE 360
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8649
Practice Address - Country:US
Practice Address - Phone:844-447-5894
Practice Address - Fax:844-447-5895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRANIAL TECHNOLOGIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-14
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier