Provider Demographics
NPI:1346432499
Name:REDMAN POWER CHAIR
Entity Type:Organization
Organization Name:REDMAN POWER CHAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-546-6002
Mailing Address - Street 1:1601 SOUTH PANTANO ROAD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-6750
Mailing Address - Country:US
Mailing Address - Phone:520-546-6002
Mailing Address - Fax:520-546-5530
Practice Address - Street 1:1601 SOUTH PANTANO ROAD
Practice Address - Street 2:SUITE 107
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6750
Practice Address - Country:US
Practice Address - Phone:520-546-6002
Practice Address - Fax:520-546-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
AZ332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ973497Medicaid
AZ4337790001Medicare NSC