Provider Demographics
NPI:1063688570
Name:COMPUMED INC
Entity Type:Organization
Organization Name:COMPUMED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-868-2555
Mailing Address - Street 1:2024 STATE STREET
Mailing Address - Street 2:PO BOX 339
Mailing Address - City:MEETEETSE
Mailing Address - State:WY
Mailing Address - Zip Code:82433-0339
Mailing Address - Country:US
Mailing Address - Phone:307-868-2555
Mailing Address - Fax:888-722-8217
Practice Address - Street 1:2024 STATE STREET
Practice Address - Street 2:
Practice Address - City:MEETEETSE
Practice Address - State:WY
Practice Address - Zip Code:82433-0339
Practice Address - Country:US
Practice Address - Phone:307-868-2555
Practice Address - Fax:888-722-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY106993400Medicaid