Provider Demographics
NPI:1316411606
Name:EXIOM, LLC
Entity Type:Organization
Organization Name:EXIOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-651-1562
Mailing Address - Street 1:440 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-1820
Mailing Address - Country:US
Mailing Address - Phone:808-651-1562
Mailing Address - Fax:
Practice Address - Street 1:440 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-1820
Practice Address - Country:US
Practice Address - Phone:808-651-1562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIVERSIFIED 3D TECHNOLOGIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-19
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment