Healthcare Provider Details

I. General information

NPI: 1073887394
Provider Name (Legal Business Name): ABOUT DISH SATELLITE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2012
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E 9TH ST SUITE 1110
CLEVELAND OH
44114-1501
US

IV. Provider business mailing address

1300 E 9TH ST SUITE 1110
CLEVELAND OH
44114-1501
US

V. Phone/Fax

Practice location:
  • Phone: 216-482-3875
  • 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 State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALISHA PICKERING
Title or Position: MANAGER
Credential:
Phone: 216-482-3875