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NPI Code Detail

MEDICARE: WAV MARKETING GROUP LLC

MEDICARE: WAV MARKETING GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333300000XEmergency Response System Companies

General Provider Information

NPI Number : 1174078836
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAV MARKETING GROUP LLC
Provider Business Mailing Address
First Line : 105 E JEFFERSON BLVD
Second Line : STE 500
City : SOUTH BEND
State : IN
Zip : 46601-1922
Country : US
Telephone Number : 574-217-3508
Fax Number :
Provider Business Practice Location Address
First Line : 105 E JEFFERSON BLVD
Second Line : STE 500
City : SOUTH BEND
State : IN
Zip : 46601-1922
Country : US
Telephone Number : 574-217-3508
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : BRANDON CHARLES DICKSON
Credential :
Telephone Number : 574-217-3508
Provider Enumeration Date : 08/23/2016
Last Update Date : 08/23/2016

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Directions to “WAV MARKETING GROUP LLC ” Practice Location

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