Provider Demographics
NPI:1013031178
Name:PRAIRIE VIEW INDUSTRIES, INC.
Entity Type:Organization
Organization Name:PRAIRIE VIEW INDUSTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STOCKHOLDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDREP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-729-4055
Mailing Address - Street 1:PO BOX 575
Mailing Address - Street 2:2620 INDUSTRIAL DRIVE
Mailing Address - City:FAIRBURY
Mailing Address - State:NE
Mailing Address - Zip Code:68352-0575
Mailing Address - Country:US
Mailing Address - Phone:402-729-4055
Mailing Address - Fax:402-729-4058
Practice Address - Street 1:2620 INDUSTRIAL DRIVE
Practice Address - Street 2:
Practice Address - City:FAIRBURY
Practice Address - State:NE
Practice Address - Zip Code:68352-0575
Practice Address - Country:US
Practice Address - Phone:402-729-4055
Practice Address - Fax:402-729-4058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies