Provider Demographics
NPI:1437285111
Name:BACK-A-LINE, INC.
Entity Type:Organization
Organization Name:BACK-A-LINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANDTBOM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:415-715-6800
Mailing Address - Street 1:644 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3613
Mailing Address - Country:US
Mailing Address - Phone:415-715-6800
Mailing Address - Fax:415-715-5684
Practice Address - Street 1:644 11TH AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3613
Practice Address - Country:US
Practice Address - Phone:415-715-6800
Practice Address - Fax:415-715-5684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies