Provider Demographics
NPI:1235135005
Name:LEWIS WHEELCHAIR REPAIR & SALES, INC.
Entity Type:Organization
Organization Name:LEWIS WHEELCHAIR REPAIR & SALES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEVASSEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-597-1026
Mailing Address - Street 1:3289 INDUSTRY DR
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-4013
Mailing Address - Country:US
Mailing Address - Phone:562-597-1026
Mailing Address - Fax:562-494-6895
Practice Address - Street 1:3291 INDUSTRY DR
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-4013
Practice Address - Country:US
Practice Address - Phone:562-597-1026
Practice Address - Fax:562-494-6895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101205332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ32666ZMedicaid
CA0301980001Medicare ID - Type Unspecified