Provider Demographics
NPI:1508018631
Name:ELIXAIR MEDICAL INC.
Entity Type:Organization
Organization Name:ELIXAIR MEDICAL INC.
Other - Org Name:ELIXAIR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BRANCH MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:KARSGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-683-3267
Mailing Address - Street 1:13 RUTHS PL STE E
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-6958
Mailing Address - Country:US
Mailing Address - Phone:360-683-3267
Mailing Address - Fax:360-683-0767
Practice Address - Street 1:13 RUTHS PL STE E
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-6958
Practice Address - Country:US
Practice Address - Phone:360-683-3267
Practice Address - Fax:360-683-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602855921332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0604320003Medicare NSC