Provider Demographics
NPI:1235326919
Name:TERRA MEDICAL INC
Entity Type:Organization
Organization Name:TERRA MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SZABOLCSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-577-0237
Mailing Address - Street 1:1297 BOUNDARY CONE RD
Mailing Address - Street 2:UNIT E
Mailing Address - City:MOHAVE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86440-8961
Mailing Address - Country:US
Mailing Address - Phone:928-577-0237
Mailing Address - Fax:928-577-0238
Practice Address - Street 1:1297 BOUNDARY CONE RD
Practice Address - Street 2:UNIT E
Practice Address - City:MOHAVE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86440-8961
Practice Address - Country:US
Practice Address - Phone:928-577-0237
Practice Address - Fax:928-577-0238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies