Provider Demographics
NPI:1407563216
Name:HOOSIER HOME SYSTEMS LLC
Entity Type:Organization
Organization Name:HOOSIER HOME SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:VEAZEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-367-1692
Mailing Address - Street 1:PO BOX 1360
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-1360
Mailing Address - Country:US
Mailing Address - Phone:425-367-1692
Mailing Address - Fax:
Practice Address - Street 1:6152 FIRE TOWER RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:IN
Practice Address - Zip Code:47167
Practice Address - Country:US
Practice Address - Phone:425-367-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage