Organization Name: | DR D DAVID PESAVENTO LTD |
NPI Number: | 1457508830 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | D DAVID PESAVENTO (OWNER) |
Mailing Address: | 963 129th Infantry Dr Suite 110 Joliet |
State: | IL US |
Postal Code: | 604352863 |
Phone Number: | 8157258425 |
Fax Number: | 8152752607 |
NPI Enumeration Date: | 08/27/2008 |
NPI Last Update Date: | 08/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 046007408 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |