Provider Demographics
NPI:1417130709
Name:ARCTIC WRAP NORTH
Entity Type:Organization
Organization Name:ARCTIC WRAP NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-761-0761
Mailing Address - Street 1:12439 MAGNOLIA BLVD
Mailing Address - Street 2:#133
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2450
Mailing Address - Country:US
Mailing Address - Phone:818-761-0761
Mailing Address - Fax:
Practice Address - Street 1:12760 BESSEMER ST
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4411
Practice Address - Country:US
Practice Address - Phone:818-761-0761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies