Healthcare Provider Details

I. General information

NPI: 1477958866
Provider Name (Legal Business Name): P.P.A.MEDICAL GROUP CO., LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89/9 THANAPORN BLD FLOOR1-2 VIBHAVADEE RANGSIT ROAD SANAMBIN
DONMUEANG BANGKOK
10210
TH

IV. Provider business mailing address

89/9 THANAPORN BLD FLOOR1-2 VIBHAVADEE RANGSIT ROAD SANAMBIN
DONMUEANG BANGKOK
10210
TH

V. Phone/Fax

Practice location:
  • Phone: 662-996-6030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateZZ

VIII. Authorized Official

Name: MS. VARAPORN SADSANGJUN
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 662-996-6030