Provider Demographics
NPI:1578681581
Name:BIKE-ON.COM, INC
Entity Type:Organization
Organization Name:BIKE-ON.COM, INC
Other - Org Name:BIKE-ON.COM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-615-0339
Mailing Address - Street 1:54 TIFFANY RD
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-4417
Mailing Address - Country:US
Mailing Address - Phone:401-615-0339
Mailing Address - Fax:401-821-7544
Practice Address - Street 1:54 TIFFANY RD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-4417
Practice Address - Country:US
Practice Address - Phone:401-615-0339
Practice Address - Fax:401-821-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI29949OtherPLAN65 PROVIDER # BCBS RI
RI=========OtherEMPLOYEE ID #