=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881964187
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WIJIT, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2012
-----------------------------------------------------
Last Update Date | 01/04/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2270 DOUGLAS BLVD STE 212
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95661-4239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-791-0505
-----------------------------------------------------
Fax | 916-780-5443
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2270 DOUGLAS BLVD STE 212
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95661-4239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-791-0505
-----------------------------------------------------
Fax | 916-780-5443
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP, FINANCE
-----------------------------------------------------
Name | MS. CHRISTINE J TAYLOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 530-574-1614
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------