Provider Demographics
NPI:1023362340
Name:ABOONDA LLC
Entity Type:Organization
Organization Name:ABOONDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-210-4333
Mailing Address - Street 1:605 W HERNDON AVE
Mailing Address - Street 2:STE 80061
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0191
Mailing Address - Country:US
Mailing Address - Phone:559-210-4333
Mailing Address - Fax:559-354-0952
Practice Address - Street 1:605 W HERNDON AVE
Practice Address - Street 2:STE 80061
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0191
Practice Address - Country:US
Practice Address - Phone:559-210-4333
Practice Address - Fax:559-354-0952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46125775332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment