Provider Demographics
NPI:1497890933
Name:CERTIFIED PROVIDERS OF AIRWAY PRODUCTS
Entity Type:Organization
Organization Name:CERTIFIED PROVIDERS OF AIRWAY PRODUCTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-348-2727
Mailing Address - Street 1:877 W FREMONT AVE
Mailing Address - Street 2:SUITE M2
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2315
Mailing Address - Country:US
Mailing Address - Phone:877-838-2711
Mailing Address - Fax:707-838-2528
Practice Address - Street 1:877 W FREMONT AVE
Practice Address - Street 2:SUITE M2
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2315
Practice Address - Country:US
Practice Address - Phone:877-838-2711
Practice Address - Fax:707-838-2528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1126980001Medicare NSC