Organization Name: | CASTLE ROCK ACCESS LLC |
NPI Number: | 1093195075 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER BAKALARS (CEO) |
Mailing Address: | 460 Clearview Ct Moorhead |
State: | MN US |
Postal Code: | 565606800 |
Phone Number: | 6124180574 |
Fax Number: | 7633228858 |
NPI Enumeration Date: | 06/04/2015 |
NPI Last Update Date: | 06/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |