Healthcare Provider Details

I. General information

NPI: 1063586238
Provider Name (Legal Business Name): SWEET STRIPS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LATHROP LN
EL CAJON CA
92021-4033
US

IV. Provider business mailing address

5465 W VALLEY RD
HASTINGS NE
68901-9704
US

V. Phone/Fax

Practice location:
  • Phone: 619-749-3756
  • Fax: 619-334-9008
Mailing address:
  • Phone: 402-461-4819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: REBECCA SUE THOMPSON
Title or Position: PARTNER
Credential:
Phone: 402-461-4819