Organization Name: | BOD SQUAD, LLC, THE |
NPI Number: | 1831325406 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAIVD STALLINGS JENSEN (OWNER) |
Mailing Address: | 1803 Abbedale Ln Sandy |
State: | UT US |
Postal Code: | 840923847 |
Phone Number: | 8017541619 |
Fax Number: | 8667641145 |
NPI Enumeration Date: | 06/09/2009 |
NPI Last Update Date: | 10/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 6342141-0144 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | UT |
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 |