Provider Demographics
NPI:1144395567
Name:DECOR OF CARLSBAD, INC.
Entity Type:Organization
Organization Name:DECOR OF CARLSBAD, INC.
Other - Org Name:DECOR FURNITURE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:QUINTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-885-8878
Mailing Address - Street 1:815 W MERMOD ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-4914
Mailing Address - Country:US
Mailing Address - Phone:505-885-8878
Mailing Address - Fax:505-887-1664
Practice Address - Street 1:815 W MERMOD ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-4914
Practice Address - Country:US
Practice Address - Phone:505-885-8878
Practice Address - Fax:505-887-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies