Provider Demographics
NPI:1033316708
Name:PHYSICIAN ENGINEERED PRODUCTS INC.
Entity Type:Organization
Organization Name:PHYSICIAN ENGINEERED PRODUCTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-935-1256
Mailing Address - Street 1:103 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1182
Mailing Address - Country:US
Mailing Address - Phone:207-935-1256
Mailing Address - Fax:207-935-1257
Practice Address - Street 1:103 SMITH ST
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1182
Practice Address - Country:US
Practice Address - Phone:207-935-1256
Practice Address - Fax:207-935-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEWH70001334332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies