Provider Demographics
NPI:1437692837
Name:CRIDHE LLC
Entity Type:Organization
Organization Name:CRIDHE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:KALINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-423-8888
Mailing Address - Street 1:9840 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-6182
Mailing Address - Country:US
Mailing Address - Phone:708-423-8888
Mailing Address - Fax:708-423-9133
Practice Address - Street 1:9840 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-6182
Practice Address - Country:US
Practice Address - Phone:708-423-8888
Practice Address - Fax:708-423-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment