Provider Demographics
NPI:1093105751
Name:ACT NOW DME LLC
Entity Type:Organization
Organization Name:ACT NOW DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:TJALAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RN
Authorized Official - Phone:866-770-7615
Mailing Address - Street 1:7620 N HARTMAN LN STE 178
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7485
Mailing Address - Country:US
Mailing Address - Phone:866-770-7615
Mailing Address - Fax:
Practice Address - Street 1:7620 N HARTMAN LN STE 178
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7485
Practice Address - Country:US
Practice Address - Phone:520-442-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZC001163332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies