1265402077 NPI number — IOTA MEDICAL EQUIPMENT INC

Table of content: (NPI 1265402077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265402077 NPI number — IOTA MEDICAL EQUIPMENT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IOTA MEDICAL EQUIPMENT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ROTECH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265402077
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 27968
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84127-0968
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-603-0033
Provider Business Mailing Address Fax Number:
863-682-6249

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 S PRICE RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAMPA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79065-6918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-665-5571
Provider Business Practice Location Address Fax Number:
806-665-8986
Provider Enumeration Date:
01/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MENCHEN
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
407-822-4600

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0914897-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".