Provider Demographics
NPI: | 1396837647 |
---|---|
Name: | LOTUSEATERS INC |
Entity Type: | Organization |
Organization Name: | LOTUSEATERS INC |
Other - Org Name: | LMI ORTHO |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ELLEN |
Authorized Official - Middle Name: | HIBBINS |
Authorized Official - Last Name: | SCLUTTO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 323-883-0011 |
Mailing Address - Street 1: | 7516 SUNSET BLVD |
Mailing Address - Street 2: | |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90046 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 323-883-0011 |
Mailing Address - Fax: | 323-883-0014 |
Practice Address - Street 1: | 7516 SUNSET BLVD |
Practice Address - Street 2: | |
Practice Address - City: | LOS ANGELES |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90046 |
Practice Address - Country: | US |
Practice Address - Phone: | 323-883-0011 |
Practice Address - Fax: | 323-883-0014 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-09-28 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | DURABLE MEDICAL EQUI | 332B00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |