Healthcare Provider Details

I. General information

NPI: 1326811365
Provider Name (Legal Business Name): CATALOG-ENTERPRISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2023
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N HALSTED ST
CHICAGO IL
60642-2517
US

IV. Provider business mailing address

1500 N HALSTED ST
CHICAGO IL
60642-2517
US

V. Phone/Fax

Practice location:
  • Phone: 800-633-0374
  • Fax:
Mailing address:
  • Phone: 800-633-0374
  • Fax:

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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ROYCE GARBUTT
Title or Position: CEO
Credential:
Phone: 800-633-0374