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General NPI Number Information
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NPI Number | 1306160205
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Entity Type | Organization
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Legal Business Name | STATE SOVEREIGNTY SOLUTIONS LLC
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Dates
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Enumeration Date | 03/21/2010
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Last Update Date | 03/21/2010
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Provider Practice Location Address
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Address Line | 348 MELWOOD AVE
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City | PITTSBURGH
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State | PA
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Zip | 15213-1302
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Country | US
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Telephone | 891-945-8765
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Fax |
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Provider Business Mailing Address
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Address Line | 348 MELWOOD AVE SUITE 101
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City | PITTSBURGH
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State | PA
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Zip | 15213-1302
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | RALPH BRAXTER
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Credential |
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Telephone | 919-948-9376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | ZZ
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