Provider Demographics
NPI:1497239545
Name:BOOMERANG TRADING COMPANY LLC
Entity Type:Organization
Organization Name:BOOMERANG TRADING COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZAT
Authorized Official - Middle Name:
Authorized Official - Last Name:OVEZOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-326-3063
Mailing Address - Street 1:700 DEMPSTER ST APT EG1
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-5020
Mailing Address - Country:US
Mailing Address - Phone:929-326-3063
Mailing Address - Fax:
Practice Address - Street 1:700 DEMPSTER ST APT EG1
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-5020
Practice Address - Country:US
Practice Address - Phone:929-326-3063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No172A00000XOther Service ProvidersDriverGroup - Single Specialty