Provider Demographics
NPI:1033486865
Name:WHEELCHAIR ACCESS VANS
Entity Type:Organization
Organization Name:WHEELCHAIR ACCESS VANS
Other - Org Name:ACCESS VANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-385-7647
Mailing Address - Street 1:6893 SUPPLY WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-5539
Mailing Address - Country:US
Mailing Address - Phone:208-385-7647
Mailing Address - Fax:
Practice Address - Street 1:6893 SUPPLY WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716-5539
Practice Address - Country:US
Practice Address - Phone:208-385-7647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment