Provider Demographics
NPI:1518323773
Name:SPECIAL PRODUCTS, LLC
Entity Type:Organization
Organization Name:SPECIAL PRODUCTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:MENDOZA
Authorized Official - Last Name:BANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-516-2605
Mailing Address - Street 1:3235 N LAKE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1966
Mailing Address - Country:US
Mailing Address - Phone:316-516-2605
Mailing Address - Fax:
Practice Address - Street 1:311 S LAURA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-1518
Practice Address - Country:US
Practice Address - Phone:316-265-4676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies