Organization Name: | PETERSON PERFORMANCE PRODUCTS, INC. |
NPI Number: | 1003856816 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MELODY ANNE PETERSON (CO-OWNER, VICE PRESIDENT, SEC/TREAS) |
Mailing Address: | 2200 Ne Neff Rd Suite 307 Bend |
State: | OR US |
Postal Code: | 977014283 |
Phone Number: | 5416171505 |
Fax Number: | 5416171527 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |