=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578852547
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVE'S CPAP SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2011
-----------------------------------------------------
Last Update Date | 03/30/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6719 E 2ND ST SUITE B
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86314-2661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-830-5699
-----------------------------------------------------
Fax | 928-775-3946
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 27503
-----------------------------------------------------
City | PRESCOTT VALLEY
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 86312-7503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 928-830-5699
-----------------------------------------------------
Fax | 928-775-3946
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ RESPIRATORY THERAPIST
-----------------------------------------------------
Name | MR. DAVID PAUL BICKERT
-----------------------------------------------------
Credential | RRT
-----------------------------------------------------
Telephone | 928-830-5699
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 11-00010799
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------