Provider Demographics
NPI:1477795367
Name:PELIKAN TECHNOLOGIES, INC.
Entity Type:Organization
Organization Name:PELIKAN TECHNOLOGIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:877-735-4526
Mailing Address - Street 1:1072 E MEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-4230
Mailing Address - Country:US
Mailing Address - Phone:877-735-4526
Mailing Address - Fax:877-216-6395
Practice Address - Street 1:1072 E MEADOW CIR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4230
Practice Address - Country:US
Practice Address - Phone:877-735-4526
Practice Address - Fax:877-216-6395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
M600100182OtherHIBCC
M600100161OtherHIBCC