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General NPI Number Information
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NPI Number | 1164736633
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Entity Type | Organization
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Legal Business Name | IPH SECURITY SYSTEMS, INC
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 706 6TH ST
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City | BROOKINGS
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State | OR
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Zip | 97415-9651
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Country | US
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Telephone | 541-469-7994
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Fax | 541-469-9359
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Provider Business Mailing Address
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Address Line | PO BOX 7074 706 6TH STREET
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City | BROOKINGS
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State | OR
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Zip | 97415
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Country | US
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Telephone | 541-469-7994
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Fax | 541-469-9359
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Authorized Official
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Title or Position | CAPTAIN/PRESIDENT
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Name | MR. THOMAS KENNETH CUTTING
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Credential | DPSST PSID 31587
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Telephone | 541-469-7994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | OR
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