Provider Demographics
NPI:1033448907
Name:DONNA BELLA LLC
Entity Type:Organization
Organization Name:DONNA BELLA LLC
Other - Org Name:DONNA BELLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-752-9649
Mailing Address - Street 1:117 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4719
Mailing Address - Country:US
Mailing Address - Phone:541-752-9649
Mailing Address - Fax:541-753-0559
Practice Address - Street 1:117 NW 2ND ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4719
Practice Address - Country:US
Practice Address - Phone:541-752-9649
Practice Address - Fax:541-753-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR6483470001Medicare NSC