Provider Demographics
NPI:1114253614
Name:IDZIOR FURNITURE CORP
Entity Type:Organization
Organization Name:IDZIOR FURNITURE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:B
Authorized Official - Last Name:IDZIOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-879-2177
Mailing Address - Street 1:4585 N HURON RD
Mailing Address - Street 2:
Mailing Address - City:PINCONNING
Mailing Address - State:MI
Mailing Address - Zip Code:48650-8405
Mailing Address - Country:US
Mailing Address - Phone:989-879-2177
Mailing Address - Fax:989-879-3045
Practice Address - Street 1:4585 N HURON RD
Practice Address - Street 2:
Practice Address - City:PINCONNING
Practice Address - State:MI
Practice Address - Zip Code:48650-8405
Practice Address - Country:US
Practice Address - Phone:989-879-2177
Practice Address - Fax:989-879-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies