Provider Demographics
NPI:1477831212
Name:CADWELL THERAPUETICS, INC.
Entity Type:Organization
Organization Name:CADWELL THERAPUETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-376-3600
Mailing Address - Street 1:909 N KELLOGG ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7669
Mailing Address - Country:US
Mailing Address - Phone:855-843-5411
Mailing Address - Fax:
Practice Address - Street 1:1035 N EMPORIA ST STE 102
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-2938
Practice Address - Country:US
Practice Address - Phone:316-347-7952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CADWELL THERAPUETICS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-3319332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment