Provider Demographics
NPI:1154629632
Name:ACME HOME ELEVATOR
Entity Type:Organization
Organization Name:ACME HOME ELEVATOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-748-4490
Mailing Address - Street 1:4740 E 2ND ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:BENICIA
Mailing Address - State:CA
Mailing Address - Zip Code:94510-1054
Mailing Address - Country:US
Mailing Address - Phone:707-748-4490
Mailing Address - Fax:707-748-0249
Practice Address - Street 1:4740 E 2ND ST
Practice Address - Street 2:SUITE 20
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-1054
Practice Address - Country:US
Practice Address - Phone:707-748-4490
Practice Address - Fax:707-748-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521967332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies