Provider Demographics
NPI:1871342303
Name:TOMAH CHEMISTS INC
Entity type:Organization
Organization Name:TOMAH CHEMISTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAIBABU
Authorized Official - Middle Name:
Authorized Official - Last Name:APPALANENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-705-8241
Mailing Address - Street 1:300 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-1636
Mailing Address - Country:US
Mailing Address - Phone:845-705-8241
Mailing Address - Fax:
Practice Address - Street 1:300 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-1636
Practice Address - Country:US
Practice Address - Phone:608-372-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies