Provider Demographics
NPI:1417275264
Name:LIFTAVATOR, INC.
Entity Type:Organization
Organization Name:LIFTAVATOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GREAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-634-1717
Mailing Address - Street 1:3302 US HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-6930
Mailing Address - Country:US
Mailing Address - Phone:252-634-1717
Mailing Address - Fax:252-634-1718
Practice Address - Street 1:3302 US HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-6930
Practice Address - Country:US
Practice Address - Phone:252-634-1717
Practice Address - Fax:252-634-1718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment