Provider Demographics
NPI:1225365539
Name:SHORT FURNITURE CO., INC.
Entity Type:Organization
Organization Name:SHORT FURNITURE CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-324-2117
Mailing Address - Street 1:319 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-2002
Mailing Address - Country:US
Mailing Address - Phone:217-324-2117
Mailing Address - Fax:217-324-7176
Practice Address - Street 1:319 N STATE ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-2002
Practice Address - Country:US
Practice Address - Phone:217-324-2117
Practice Address - Fax:217-324-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL02032422332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies