Healthcare Provider Details

I. General information

NPI: 1336474394
Provider Name (Legal Business Name): SMART ENERGY DESIGN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 10/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FLORA PAGO GARDENS
CHALAN PAGO GU
96932
US

IV. Provider business mailing address

PO BOX DB
AGATNA GU
96932
US

V. Phone/Fax

Practice location:
  • Phone: 671-688-3455
  • Fax:
Mailing address:
  • Phone: 671-688-7511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: CLIFFORD PATRICK SHOEMAKE
Title or Position: PRESIDENT
Credential:
Phone: 671-688-3455