Healthcare Provider Details

I. General information

NPI: 1457894222
Provider Name (Legal Business Name): INDEELIFT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2016
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5143 TESLA RD
LIVERMORE CA
94550-9619
US

IV. Provider business mailing address

5143 TESLA RD
LIVERMORE CA
94550-9619
US

V. Phone/Fax

Practice location:
  • Phone: 925-455-5438
  • Fax: 925-373-6646
Mailing address:
  • Phone: 925-455-5438
  • Fax: 925-373-6646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN JAY POWELL SR.
Title or Position: CEO
Credential:
Phone: 925-519-0156