Organization Name: | JR STEWART D.D.S. ENTERPRISES LLC |
NPI Number: | 1982031928 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH R STEWART (DR.) |
Mailing Address: | 108 South Illinois Street Wanatah |
State: | IN US |
Postal Code: | 463900359 |
Phone Number: | 2197332929 |
Fax Number: | 2197331329 |
NPI Enumeration Date: | 10/05/2013 |
NPI Last Update Date: | 10/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 8658 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |