Provider Demographics
NPI:1396041935
Name:RV SCOOTER SALS
Entity Type:Organization
Organization Name:RV SCOOTER SALS
Other - Org Name:GRUNDY NATIONAL HOMECARE SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:319-989-2748
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:DIKE
Mailing Address - State:IA
Mailing Address - Zip Code:50624-0214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:755 FOX RIDGE RD
Practice Address - Street 2:
Practice Address - City:DIKE
Practice Address - State:IA
Practice Address - Zip Code:50624-9632
Practice Address - Country:US
Practice Address - Phone:319-989-2748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-30
Last Update Date:2011-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies