MEDICARE: RETRAINER INC.

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1922442029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETRAINER INC.

Provider Business Mailing Address
First Line	:	6045 POOH CORNER COURT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110
Country	:	US
Telephone Number	:	801-636-7550
Fax Number	:	702-988-8812

Provider Business Practice Location Address
First Line	:	6045 POOH CORNER COURT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110
Country	:	US
Telephone Number	:	801-636-7500
Fax Number	:	702-988-8812

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DARREN JOHN SIEBEN
Credential	:
Telephone Number	:	702-466-7712

Provider Enumeration Date	:	04/19/2013
Last Update Date	:	05/03/2013

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