Provider Demographics
NPI:1558693002
Name:TELESTO MEDTECH LLC
Entity Type:Organization
Organization Name:TELESTO MEDTECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-621-8011
Mailing Address - Street 1:464 COMMON ST
Mailing Address - Street 2:SUITE 365
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2704
Mailing Address - Country:US
Mailing Address - Phone:831-621-8011
Mailing Address - Fax:831-621-3969
Practice Address - Street 1:464 COMMON ST
Practice Address - Street 2:SUITE 365
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2704
Practice Address - Country:US
Practice Address - Phone:831-621-8011
Practice Address - Fax:831-621-3969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment