1326478330 NPI number — CARDIAC LIFE PRODUCTS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326478330 NPI number — CARDIAC LIFE PRODUCTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIAC LIFE PRODUCTS, 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:
Provider Other Organization Name Type Code:
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:
1326478330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25755
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14625-0755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-267-7775
Provider Business Mailing Address Fax Number:
585-267-5218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
349 W COMMERCIAL ST
Provider Second Line Business Practice Location Address:
SUITE 1400
Provider Business Practice Location Address City Name:
EAST ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14445-2407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-286-3811
Provider Business Practice Location Address Fax Number:
585-286-3822
Provider Enumeration Date:
11/13/2013

Additional Information

Authorized Official

Authorized Official Last Name:
WYNNE
Authorized Official First Name:
MARY
Authorized Official Middle Name:
BEKE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
585-267-7775

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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