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General NPI Number Information
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NPI Number | 1659111953
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Entity Type | Organization
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Legal Business Name | PLUSH DOLLHAUS CO.
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Dates
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Enumeration Date | 05/27/2024
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 1846 E INNOVATION PARK DR STE 100
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City | ORO VALLEY
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State | AZ
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Zip | 85755-1963
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Country | US
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Telephone | 386-293-4710
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Fax |
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Provider Business Mailing Address
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Address Line | 1666 S EXTENSION RD APT 17-106
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City | MESA
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State | AZ
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Zip | 85210-9310
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Country | US
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Telephone | 386-293-4710
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAYAUJANAE JOHNSON
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Credential |
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Telephone | 386-293-4710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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