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General NPI Number Information
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NPI Number | 1699975284
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Entity Type | Organization
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Legal Business Name | TAYLOR ENTERPRISES 2, INC.
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 04/07/2008
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Provider Practice Location Address
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Address Line | 1560 E CHERRY ST SUITE 101
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3435
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Country | US
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Telephone | 928-634-8283
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Fax | 928-649-1914
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Provider Business Mailing Address
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Address Line | 1560 E CHERRY ST SUITE 101
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3435
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Country | US
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Telephone | 928-634-8283
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Fax | 928-649-1914
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROD A TAYLOR
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Credential |
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Telephone | 928-634-8283
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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 | 20174041
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License Number State | AZ
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