Provider Demographics
NPI:1164801577
Name:CKOETTER COMPANY, LLC
Entity Type:Organization
Organization Name:CKOETTER COMPANY, LLC
Other - Org Name:NORTH TEXAS MOBILITY LIFTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SHAUN
Authorized Official - Last Name:KOETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-322-0900
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76307-0564
Mailing Address - Country:US
Mailing Address - Phone:940-322-0900
Mailing Address - Fax:940-322-0902
Practice Address - Street 1:1716 E SCOTT AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-8018
Practice Address - Country:US
Practice Address - Phone:940-322-0900
Practice Address - Fax:940-322-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment