Provider Demographics
NPI:1265831572
Name:VERADYNE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:VERADYNE ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-660-3389
Mailing Address - Street 1:2532 N 4TH ST
Mailing Address - Street 2:SUITE #453
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-3712
Mailing Address - Country:US
Mailing Address - Phone:206-660-3389
Mailing Address - Fax:
Practice Address - Street 1:2532 N 4TH ST
Practice Address - Street 2:SUITE #453
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3712
Practice Address - Country:US
Practice Address - Phone:206-660-3389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies