Provider Demographics
NPI:1578895801
Name:19TH HOLE GOLF CARTS CORP.
Entity Type:Organization
Organization Name:19TH HOLE GOLF CARTS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOIZU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-699-3989
Mailing Address - Street 1:PO BOX 981
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92593-0981
Mailing Address - Country:US
Mailing Address - Phone:951-699-3989
Mailing Address - Fax:951-699-0089
Practice Address - Street 1:28822 OLD TOWN FRONT ST
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2859
Practice Address - Country:US
Practice Address - Phone:951-699-3989
Practice Address - Fax:951-699-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies