Provider Demographics
NPI:1871893909
Name:STREETSTRIDER INTERNATIONAL LLC
Entity type:Organization
Organization Name:STREETSTRIDER INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/INVENTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-222-1084
Mailing Address - Street 1:204 W SPEAR ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4160
Mailing Address - Country:US
Mailing Address - Phone:800-348-0998
Mailing Address - Fax:866-565-0637
Practice Address - Street 1:204 W SPEAR ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4160
Practice Address - Country:US
Practice Address - Phone:800-348-0998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE