1831407584 NPI number — CLICK WHEELCHAIR SERVICES

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 1831407584 NPI number — CLICK WHEELCHAIR SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLICK WHEELCHAIR SERVICES
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:
1831407584
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2429 DALWORTH ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75050-4980
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-412-3272
Provider Business Mailing Address Fax Number:
866-670-6805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2429 DALWORTH ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
GRAND PRAIRIE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75050-4980
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-412-3272
Provider Business Practice Location Address Fax Number:
866-670-6805
Provider Enumeration Date:
09/15/2010

Additional Information

Authorized Official

Authorized Official Last Name:
SKERTICH
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
FRANCIS
Authorized Official Title or Position:
OFFICER
Authorized Official Telephone Number:
866-670-6805

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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