| Organization Name: | ROTH MEDICAL INC |
| NPI Number: | 1841251485 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBIN L MENCHEN (CHIEF OPERATING OFFICER) |
| Mailing Address: | 225 N Lemay Ave Suite 3 Ft Collins |
| State: | CO US |
| Postal Code: | 805242565 |
| Phone Number: | 9702242828 |
| Fax Number: | 9702242517 |
| NPI Enumeration Date: | 03/31/2006 |
| NPI Last Update Date: | 03/01/2016 |
| 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: | |